显微外科手术治疗颅内动脉瘤32例

目的 :介绍 32例颅内动脉瘤显微神经外科手术的经验 ,探讨手术时机、显微手术技巧及有关并发症的防治。方法 :在气管插管全麻及控制性低血压下进行显微手术。多采用改进的 Yasargil入路 ,在显微镜直视下操作 ,解剖动脉瘤蒂 ,准确地夹闭瘤蒂。结果 :本组 32例患者中行动脉瘤蒂夹闭术 2 9例 ,切除术 2例 ,包裹 1例 ,治愈率 90 .6 %,死亡率 9.4%。术中动脉瘤破裂 5例 ,死亡 2例 ,死亡率 40 %。结论 :显微神经外科手术技术提高了颅内动静脉瘤的手术成功率 ,术前病情过重及动脉瘤术中破裂出血是手术失败和死亡的主要原因。

Microsurgical treatment of intracranial aneurysms for 32 cases

Objective:Experience of microneurosurgery for treatment of intracranial aneurysms were report.To discuss the technique of microsurgery,the prevention and treatment of the complications,the time of operation.Methods:All operations were carried on with controlled hypotension and general aneshesia.Modified Yasargil′s approach were adopted for the most patients.All protocols of surgery and placing aneurysin clips were under microscope.Results:29 aneurysms of 32 cases were completely clipped by aneurysm clips.The two-aneurysm bodies were excised and one aneurysm were wrapping and encasement.The total cure rate was 90.6 percent and the mortality was 9.4 percent.There were 5 cases ruptured during operation,2 cases of which were died,the mortality was 40 percent.Conclusion:Skillful microsurgery technique raised the success rate of operation.The main causes of failure and death were the rupture of aneurysm during operation and the disease (the preoperative grade) was too serious.