显微手术治疗颅内动脉瘤72例体会

目的探讨显微镜下颅内动脉瘤的手术策略、术中处理及其疗效。方法采用夹闭、切除、孤立、包裹等方法手术处理72例共90个动脉瘤,共夹闭78个动脉瘤,12个行动脉瘤孤立、包裹。8例较巨大动脉瘤,均在钳夹后取出瘤内血栓或切除瘤体。结果 72例术后1个月按GOS标准评定疗效,恢复良好62例（86.1%）,中残或重残7例（9.7%）,死亡3例（4.2%）。随访69例（3～60个月）,恢复良好67例（97.1%）,中残或重残2例（2.9%）,死亡0例。51例行CTA复查,动脉瘤夹闭满意。结论显微镜下手术夹闭是治疗动脉瘤的确实有效的方法。术中采用充分的显露,血管临时阻断,巨大动脉瘤切开减压,可达到满意的手术效果。

Experience in microsurgical operative treatment of intracranial aneurysms

Objective To study the surgical techniques, intraoperative treatment, and curative effect in patients with intracranial aneurysms. Methods From June 2005 to June 2010, 72 patients with number of 90 intracranial aneurysms underwent the surgical procedure with clipping, resecting, trapping and coating. Among of all, the number of 78 was clipped, and 12 was trapped and coated. 8 case with giant aneurysms was resected and removal internal ciots after clipping. Results All patients revelation were satisfaction 1 months after operation. The prognosis was assessed by GOS, and showed as follows: good in 62 casesv(86.1%),vpoor in 7 cases, and 3 died. Long-term follow-up was performed in 65 patients, of whom, 62(95.4%) were recovered well, 3 moderately or severely disabled, without dead. Conclusion Microsurgical operative treatment of intracranial aneurysms was the most effective method. The techniques and methods of sufficient exposure, temporary occlusion of the parent artery, and reduction of intraaneurysmal pressure, were reliable and effective in process.