大脑中动脉瘤的显微手术治疗体会(附35例报告)

目的 探讨显微外科手术处理大脑中动脉瘤(MCAA)的临床经验.方法 回顾性分析2004-2008年行显微手术治疗的35例MCAA患者的临床资料,其中男20例,女15例,年龄18～72岁,平均40岁.35例中22例曾有蛛网膜下隙出血,11例伴颅内血肿,1例伴硬膜下血肿;动脉瘤发生部位:MCA主干10例,分叉部20例,远端5例,其中1例分叉部有两个动脉瘤;左侧13例,右侧22例;巨型7例,大型11例,小型17例.35例均采用显微手术治疗,根据动脉瘤的位置而采取不同的于术人路,其中3例伴有颅内巨大血肿经颞上回入路行手术,1例巨大动脉瘤行左颞浅动脉大脑中动脉吻合术后行载瘤动脉阻断术,1例巨大动脉瘤行动脉瘤孤立、大隐静脉大脑中动脉架桥术.结果 巨型及大型MCAA占总例数的51.4%.与术前相比较,35例患者中术后症状好转20例,无变化12例,出现术后并发症3例,无一例死亡.结论 LWEAA易形成巨大动脉瘤;正确的手术入路及熟练的操作技术有助于提高手术效果.

Microsurgical treatment of middle cerebral artery aneurysm:analysis of 35 cases

Objective To summarize the experiences of microsurgery for treatment of middle cerebral artery aneurysms (MCAA). Methods The clinical data of 35 patients with MCAA treated by microsurgery in General Hospital of PLA from 2004 to 2008 were retrospectively reviewed. Of them there were 20 males and 15 females, aged 18 to 72 years with a mean of 40 years. Of the 35 patients, subarachnoid hemorrhage occurred formerly in 22, intracerebral hemorrhage occurred in 11 and subdural hematoma in one patient. The MCAA loc...