显微手术治疗颈内-后交通动脉瘤53例

目的探讨显微手术治疗颈内-后交通动脉瘤的方法、时机、并发症以及术中动脉瘤破裂和多发动脉瘤的处理。方法采用常规翼点及其改良入路,显微手术夹闭颈内-后交通动脉瘤51例,其中1例双侧后交通动脉瘤从一侧入路夹闭;行动脉瘤孤立术2例。结果本组51例均顺利夹闭瘤颈。术中有6例出现动脉瘤破裂,其中2例因动脉瘤无法夹闭而行动脉瘤孤立术,1例患者术后死亡,总死亡率1.89%(1/53)。结论显微手术仍具有介入治疗无法替代的优点,早期手术不仅可以降低等待手术期间再次出血的机率,还有利于动眼神经麻痹的恢复。

Microsurgery for Posterior Communicating Artery Aneurysms: a Report of 53 Cases

Objective To explore the technique, time and complication of microsurgery for posterior communicating artery aneurysms (PcoAA) and treatment of the intraoperative rupture of aneurysm and multiple intracranial aneurysm. Methods Of 53 cases of PcoAA treated by microsurgery through the pterion or modified pterion approach, 51 were clipped and 2 trapped. Results Fifty-one cases of aneurysms were successfully clipped. The aneurysms trapping was successfully performed in 2 of 6 patients in whom the aneurysms ruptured during the operation. One patient died after the operation due to intraoperative rupture of aneurysm. Conclusions The microsurgery still is an important method to treat the intracranial aneurysm. Once the aneurysm is definitely diagnosed, the operation should be performed as early as possible for preventing the aneurysm from rebleeding and promoting the recovery of oculomotor paralysis.