单侧颈总动脉结扎治疗颈内动脉颅内段动脉瘤(附8例报道)

目的 探讨颈总动脉结扎治疗颈内动脉颅内段动脉瘤的适应证、手术方法及并发症的预防.方法 8例患者均为DSA确定的颈内动脉颅内段动脉瘤,颈内动脉海绵窦段假性动脉瘤3例,颈内动脉床突旁梭形动脉瘤4例,颈内动脉床突上段梭形动脉瘤1例.其中6例经2周以上压颈（Matas＇ test）试验,一次性结扎颈总动脉,另两例未经压颈（Matas＇ test）试验准备,采用Crutchfield夹缓慢夹闭的方法结扎颈总动脉.结果 8例患者颈总动脉结扎后术前症状均得到改善,CT复查显示动脉瘤内血栓形成.结论 颈总动脉结扎对于一些手术、介入难以处理的颈内动脉颅内段动脉瘤是一种简单、有效的方法,但是存在较高的风险,需要耐心和充分的术前准备.

Intercranial aneurysms treated with ligation of unilateral carotid (report of 8 cases)

[Objective] To dicuss the indication, operative means and prevention of complications of intercranial aneurysms treated with ligation of unilateral carotid. [Method] There were 3 intercavernous pseudoaneurysms, 4 paraclinoid-process fusiform aneurysms and 1 superclinoid-process fusiform aneurysms. All was confirmed by DSA. Afer Matas' test for 2 weeks, 6 of 8 cases was treated by ligation of the common carotid directly in one operation. 2 by ligation of the common carotid in 2 or more operations without preparation of Matas' test. [Result] The symptoms of all cases were improved or disappear postoperatively, CT reveal the form of thrombosis in aneurysms. [Conclusion] Ligation of the common carotid is a simple and effective means to deal with refractory aneurysms. Due to the high risk, sufficient preparation is needed preoperatively.