基底动脉末段动脉瘤术中基底动脉的临时阻断

目的探讨基底动脉末段动脉瘤显微外科术中采用基底动脉临时阻断(TBAO)的可行性.方法回顾性分析892例基底动脉末段(基底动脉分叉部和基底动脉-小脑上动脉)非巨大动脉瘤显微外科术中采用TBAO与非TBAO的疗效并进行比较.结果单次阻断不超过5 min比较安全,超时或重复阻断则病残和死亡率增加;TBAO应慎重地用于术前不良分级、老年和多发性动脉瘤的患者,阻断的同期使用低血压(平均动脉压<70 mmHg)应视为禁忌.结论基底动脉动脉瘤早期外科治疗中采用TBAO较非TBAO疗效好.

Temporary basilar artery occlusion in the management of basilar tip aneurysms

Objective To discuss the feasibility of temporary basilar artery occlusion (TBAO) in the microsurgical management of basilar tip aneurysms.Methods To analyze and compare the effects of TBAO with non-TBAO during basilar tip (bifurcation of basilar artery and basilar-superior cerebellar artery) non-giant aneurysms microsurgery with prospective study.Results TBAO was completely safe if single occlusion time did not exceed five minutes. If single TBAO time was more than five minutes, or if repeating TBAO was used, the operative morbidity and mortality would increase. TBAO should be used cautiously in patients with poor preoperative grade, in aged patients and in patients with operation for associated aneurysms. Simultaneous use of hypotension (MABP< 70 mmHG) was contraindicated.Conclusion The effect of applying TBAO is better than that of non-TBAO during early microsurgery for basilar tip aneurysms.