双侧后交通动脉瘤显微手术治疗

目的 介绍8例双侧颈内动脉-后交通动脉瘤显微手术的经验,对其显微手术的方法、方式及手术时机等进行探讨. 方法 常规采用翼点及其改良入路,在显微镜直视下操作,行动脉瘤颈夹闭术,并尝试从一侧入路夹闭双侧后交通动脉瘤. 结果 本组8例均顺利夹闭瘤颈,其中7例行一期手术夹闭动脉瘤,术中动脉瘤均未破裂,无死亡. 结论 早期手术及一期夹闭双侧动脉瘤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.术前判断动脉瘤的位置、大小和指向对于预防术中动脉瘤破裂和决定是否从一侧入路夹闭双侧动脉瘤是十分重要的.

Ambilateral Posterior Communicating Aneurysm Treated by Micrurgy

Objective To introduce experience of ambilateral posterior communicating aneurysms(PcoAA)that treated by micrurgy, and discussed its operating modus and operating juncture.Methods Modified Yasargil's approach were adopted. All protocols of surgery and placing aneurysm clips were under microscope, and try to clip ambilateral aneurysm from mono-lateral approach.Results All aneurysms of 8 cases were clipped by aneurysm clips. In which seven cases were clipped in onestage operation, all aneurysm were not ruptured in operation, and no patient died.Conclusion Operation in earlier period can not only degrade the probability of rebleeding during the period of waiting for operation, but also profit to the recovery of oculomotor paralysis. A definite judgment of the location, size and direction of the aneurysm before operation is very important to determine whether clip ambilateral aneurysm from mono-lateral approach.