CAJ | 학술논문

目的总结2006年1月至2009年12月我科收治的10例大脑后动脉动脉瘤的临床特征、手术入路和手术技巧.方法 10例中P1段3例,P2段5例,P3段2例.P1段动脉瘤采用颞下+翼点联合入路,P2、P3段动脉瘤采用颞下入路.在微血管多普勒监测下7例行动脉瘤颈夹闭术,2例行血管塑形动脉瘤夹闭术,1例行动脉瘤孤立术.其中3例巨大动脉瘤行动脉瘤切除术.结果 10例患者中6例恢复良好,2例术后出现动眼神经麻痹,1例出现同向偏盲,1例出现轻偏瘫,经治疗后均恢复正常.术前1例存在动眼神经麻痹和1例存在同向偏盲者手术后3个月恢复.结论显微外科手术是治疗大脑后动脉瘤的主要方法,经颞下入路暴露充分,是一种安全、简便的入路.微血管多普勒在动脉瘤夹闭术中是一种直接、有效和便捷的监测方法,对提高手术治疗效果具有重要价值.
목적 총결2006년1월지2009년12월아과수치적10례대뇌후동맥동맥류적림상특정、수술입로화수술기교.방법 10례중P1단3례,P2단5례,P3단2례.P1단동맥류채용섭하+익점연합입로,P2、P3단동맥류채용섭하입로.재미혈관다보륵감측하7례행동맥류경협폐술,2례행혈관소형동맥류협폐술,1례행동맥류고립술.기중3례거대동맥류행동맥류절제술.결과 10례환자중6례회복량호,2례술후출현동안신경마비,1례출현동향편맹,1례출현경편탄,경치료후균회복정상.술전1례존재동안신경마비화1례존재동향편맹자수술후3개월회복.결론 현미외과수술시치료대뇌후동맥류적주요방법,경섭하입로폭로충분,시일충안전、간편적입로.미혈관다보륵재동맥류협폐술중시일충직접、유효화편첩적감측방법,대제고수술치료효과구유중요개치.
Objective To summarize the clinical features of intracranial aneurysms of posterior cerebral artery (PCA), and the surgical approaches and operative skills to treat them. Method The aneurysms arose from the P1 segment in 3 patients, the P2 segment in 5 patients and the P3 segment in 2 patients. Aneurysms on P1 segment were surgically treated via subtemporal associated pterional approach. Aneurysms on P2 and P3 segment were surgically treated via subtemporal approach. 7 aneurysms were successfully treated by clipping the aneurysmal neck,2 aneurysms were shaped and 1 aneurysm was isolated. 3 giant aneurysms were resected. Microvascular Doppler was conducted to examine the blood flow of aneurysms and parent arteries. Results 6 of 10 patients had postoperative good recovery. Temporal oculomotor palsy occurred in 2 patients, syntropic hemiablepsia occurred in 1 patients,light hemiplegia in 1 patient. All these patients were recovery with treatment. 1 oculomotor palsy and 1 syntropic hemiablepsia preoperation recovered postoperation after three months. Conclusions The microsurgery is one of the major methods for treating aneurysm of PCA. The subtemporal approach in treating aneurysm of PCA is simple,safe and good exposure. Microvascular doppler is a feasible, safe, and very reliable technique in aneurysm surgery.