经翼点入路前循环动脉瘤显微手术治疗

目的总结前循环动脉瘤手术时机及翼点入路显微手术术中、术后的治疗经验。方法36例前循环动脉瘤显微手术，其中瘤颈夹闭术35例，瘤壁加固术1例。术式采用Yasargil翼点入路，近侧载瘤动脉暂时阻断，夹闭瘤颈。结果术后患者预后根据GOS分级评定：Ⅵ级31例，Ⅳ级3例，Ⅲ级1例，因术后严重脑血管痉挛死亡1例。治疗良好率达86％以上。结论手术时机的把握及术中操作、术后脑血管痉挛防治是前循环动脉瘤治疗成功的关键。

Microsurgicai treatment of anterior circulation aneurysm through pterional approach

Objetive To summarise the treatment experience of front circulation aneurysm operative time and intraoperative and postoperative pterion approach. Method Of 36 patients with front circulation aneurysm microsurgery, 35 were clipped the aneurysm neck and one was reinforced the aneurysm wall. Operation type was used by the yasargil pterion approach, which the carrying arteries were in temporary occlusion and the aneurysm neck were clipped. Results According to GOS classification assessment for postoperative patients prognosis, 31 cases belonged in grade V, 3 in grade IV and one in grade m. One patient died of serious cerebral vessel spasm. Treatment of a good rate was more than 86%. Conclusion Mastery of operation timing and prevention and treatment of intraoperative and postoperative cerebral vessel spasm are key to the front circulation aneurysm.