摘要
目的：探讨显微手术治疗后交通动脉瘤的手术时机，避免术后脑积水的手段及双侧后交通动脉瘤的处理方法。方法：采用翼点入路，早期显微手术夹闭后交通动脉瘤41例，两例双侧后交通动脉瘤患者成功采用一侧翼点入路夹闭双侧动脉瘤。结果：本组41例动脉瘤均顺利夹闭，28例患者术前存在动眼神经麻痹，27例术后症状消失或者缓解，1例未有明显改善。41例患者均行终板造瘘，术后出现脑积水患者1例。无死亡病例。随访1～10月无动脉瘤残留及复发。结论：早期手术夹闭后交通动脉瘤有利于动眼神经麻痹的恢复，术中行终板造瘘可降低术后脑积水的发生，对侧后交通动脉瘤的指向、位置及后交通动脉与颈内动脉的解剖关系是影响一侧入路夹闭双侧后交通动脉瘤的关键因素。
Objective： To investigate microsurgical timing of posterior communicating artery aneurysm （PcoA）, to avoid postoper- ative hydrocephalus and to investigate the treatment for bilateral PcoA. Methods： 41 cases adopted early pterion microsurgical clipping treatment. 2 cases of bilateral PcoA patients successfully conducted the pterion clamping bilateral aneurysms. Results： All 41 patients un- derwent endplate colostomy and aneurysm were successfully clipped. 28 patients with preoperative oculomotor nerve palsy, of whom 27 cases of postoperative symptoms disappeared or alleviated and 1 case had no significant improvement. One patient got postoperative hy- drocephalus. No deaths appeared. In 1-10 months follow-up, there were no aneurysm residual and recurrence. Conclusion： Early surgical clipping is beneficial to oculomotor nerve palsy recovery. Intraoperative endplate colostomy can reduce the incidence of postoperative hydrocephalus. Point or location of contralateral PcoA and relationship between PcoA and ICA are key factors that affect one side opera- tive route for the clipping the bilateral PcoA.
出处
《现代生物医学进展》
CAS
2013年第34期6679-6681,共3页
Progress in Modern Biomedicine
关键词
显微手术
后交通动脉瘤
Micro-surgery
Posterior communicating artery aneurysm
