摘要
目的评估后交通动脉瘤瘤体指向对于后交通动脉瘤夹闭术中、术后并发症的影响。方法回顾性分析2014年6月至2018年6月间在连云港市第一人民医院就诊的后交通动脉瘤破裂3d内行夹闭术且均在术后3d内行头颅CT平扫的患者共76例,动脉瘤根据瘤体的指向被分为向后方和侧方指向两组,动脉瘤的特征和术中情况均详细记录。研究分析两组不同指向动脉瘤间的特征和术中情况、术后CT检查结果的差异。结果向后和侧方指向的后交通动脉瘤两组间的Hunt-Hess分级、瘤颈比、初始脑内血肿的出现差异有统计学意义(P<0.05);术中破裂、跨血管夹的使用、动脉瘤与周围穿动脉粘连、术后梗塞、术后血肿的发生率两组间比较差异有统计学意义(P<0.05)。结论向后指向比向侧方指向的后交通动脉瘤发生夹闭术中和术后并发症的概率更高。
Objective To evaluate the impact of the direction of aneurysm projection of ruptured posterior communicating artery aneurysms on the incidence of intraoperative and postoperative complications during surgical clipping.Methods A retrospective analysis was conducted for clinical data of 76 patients with posterior communicating artery aneurysms who underwent clipping for 3 days and underwent head CT scan within 3 days after the surgery in the First People′s Hospital of Lianyungang from June 2014 to June 2018.Aneurysms were divided into posterior and lateral group.The characteristics of aneurysms and intraoperative conditions were recorded in detail.The characteristics of the two groups of different aneurysms and intraoperative complications and the difference of postoperative CT findings were recorded and compared.Results The Hunt-Hess grade,the aspect ratio,and the initial intracerebral hematoma between the two groups of different projections of posterior communicating artery aneurysms were statistically significant(P<0.05).Intraoperative rupture,use of fenestrated clips,dense adherence of posterior communicating artery aneurysms or its perforators,postoperative infarction,and postoperative hematoma were statistically significant(P<0.05).Conclusions Intraoperative and postoperative complications are more likely to occur in ruptured posterior communicating artery aneurysm with posterior projection during surgical clipping than in that with lateral projection.
作者
徐伦
顾艳
骆孟
刘永保
刘希光
张洪伟
XU Lun;GU Yan;LUO Meng;LIU Yongbao;LIU Xiguang;ZHANG Hongwei(Department of Neurosurgy,Lianyungang Hospital of Traditional Chinese Medicine,Lianyungang 222004,China)
出处
《实用医学杂志》
CAS
北大核心
2019年第17期2726-2730,2736,共6页
The Journal of Practical Medicine
基金
江苏省卫生健康委面上项目(编号:H2018091)
关键词
后交通动脉瘤
动脉瘤指向
并发症
术中破裂
瘤颈比
posterior communicating artery aneurysm
aneurysm projection
complication
intraoperative rupture
aspect ratio
