中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2011年
7期
652-655
,共4页
刘峥%王守森%王如密%郑兆聪%洪景芳%荆俊杰%魏梁锋%高进喜%张小军%李琦
劉崢%王守森%王如密%鄭兆聰%洪景芳%荊俊傑%魏樑鋒%高進喜%張小軍%李琦
류쟁%왕수삼%왕여밀%정조총%홍경방%형준걸%위량봉%고진희%장소군%리기
外科手术%血泡样动脉瘤%颈内动脉
外科手術%血泡樣動脈瘤%頸內動脈
외과수술%혈포양동맥류%경내동맥
Surgical procedures,operative%Blood blister - like aneurysm%Carotid artery,internal
目的 探讨颈内动脉床突上段血泡样动脉瘤(BBA)的手术技巧.方法 对7例开颅手术夹闭的BBA进行分析,采取额极软脑膜下分离,预先或术中临时阻断载瘤动脉,直接游离瘤颈两侧或载瘤动脉相连续部,分离出能够通过动脉瘤夹闭小空间即可,不必完全显露瘤体;强调选用小弯形动脉瘤夹一次夹闭,如果瘤颈撕裂在载瘤动脉临时孤立无充盈状态下,将瘤颈根部包括载瘤动脉壁连续部部分动脉壁一并夹闭.结果 本组6例术后完全康复;1例术后2周出现大脑半球大面积梗死,肢体偏瘫,痴呆.结论 采用特殊的手术技巧,能够减少BBA的手术风险,提高治愈率.
目的 探討頸內動脈床突上段血泡樣動脈瘤(BBA)的手術技巧.方法 對7例開顱手術夾閉的BBA進行分析,採取額極軟腦膜下分離,預先或術中臨時阻斷載瘤動脈,直接遊離瘤頸兩側或載瘤動脈相連續部,分離齣能夠通過動脈瘤夾閉小空間即可,不必完全顯露瘤體;彊調選用小彎形動脈瘤夾一次夾閉,如果瘤頸撕裂在載瘤動脈臨時孤立無充盈狀態下,將瘤頸根部包括載瘤動脈壁連續部部分動脈壁一併夾閉.結果 本組6例術後完全康複;1例術後2週齣現大腦半毬大麵積梗死,肢體偏癱,癡呆.結論 採用特殊的手術技巧,能夠減少BBA的手術風險,提高治愈率.
목적 탐토경내동맥상돌상단혈포양동맥류(BBA)적수술기교.방법 대7례개로수술협폐적BBA진행분석,채취액겁연뇌막하분리,예선혹술중림시조단재류동맥,직접유리류경량측혹재류동맥상련속부,분리출능구통과동맥류협폐소공간즉가,불필완전현로류체;강조선용소만형동맥류협일차협폐,여과류경시렬재재류동맥림시고립무충영상태하,장류경근부포괄재류동맥벽련속부부분동맥벽일병협폐.결과 본조6례술후완전강복;1례술후2주출현대뇌반구대면적경사,지체편탄,치태.결론 채용특수적수술기교,능구감소BBA적수술풍험,제고치유솔.
Objective To explore the surgical techniques for rare blood blister - like aneurysm (BBA) in the superior segment of clinoid process of internal carotid artery. Method The clinical data of seven cases of BBAs were studied. The separation of pia mater of the frontal pole was performed. The parent artery was blocked temporarily during the surgery. Sculpture type was adopted to directly dissociate the continuation part between the aneurysm neck and parent artery to get a small space enough for incarceration of aneurysm without exposure of the entire aneurysm. One incarceration of the lesser curvature - like aneurysm clip was specially performed to temporarily isolate the parent artery in the case of avulsion of aneurysm neck,to incarcerate the aneurysm root including the continuous part of parent artery wall in a nonfilling state. Results There were 6 cases of complete recovery after operation, 1 case of large area infarction of hemicerebrum after 2 weeks of operation resulting in hemiplegia and dementia Conclusions Special surgical techniques could reduce the surgical risk for BBA and improve curative rate.
