CAJ | 학술논문

目的：分析前交通动脉（Anterior Communicating Artery，ACoA）瘤破裂显微手术夹闭的临床效果。方法选取2000年1月~2013年8月来我院就诊的破裂前交通动脉瘤患者，要求手术夹闭治疗者，共54例，收集分析他们的临床资料。结果手术中有8例动脉瘤破裂出血。48例患者术后恢复良好，4例术后并发脑梗塞导致偏瘫，2例Hunt-HessⅣ级患者中，1例术中因大出血死亡，1例术后因呼吸衰竭死亡。术后随访无复发。结论显微手术夹闭前交通动脉瘤安全可靠，效果不容置疑。但应该注意选择适应症和手术时机。术中配合控制性低血压，应用临时阻断技术，进行终板造瘘等措施，可以取得更好的治疗效果。
목적：분석전교통동맥（Anterior Communicating Artery，ACoA）류파렬현미수술협폐적림상효과。방법선취2000년1월~2013년8월래아원취진적파렬전교통동맥류환자，요구수술협폐치료자，공54례，수집분석타문적림상자료。결과수술중유8례동맥류파렬출혈。48례환자술후회복량호，4례술후병발뇌경새도치편탄，2례Hunt-HessⅣ급환자중，1례술중인대출혈사망，1례술후인호흡쇠갈사망。술후수방무복발。결론현미수술협폐전교통동맥류안전가고，효과불용치의。단응해주의선택괄응증화수술시궤。술중배합공제성저혈압，응용림시조단기술，진행종판조루등조시，가이취득경호적치료효과。
Objective:To investigate clinical results of the microsurgery clipping of the anterior communicating artery (ACoA) aneurysm. Methods: we col ect a total of 54 cases diagnosed as ruptured anterior communicating artery aneurysm that had craniotomy clipping from January 2000 to August 2013 at our hospital,and analyze their clinical data. Results:There are 8 cases experiencing aneurysm rupture during the craniotomy.48 patients recovered wel ,4 cases suf ered hemiplegia due to postoperative cerebral infarction,2 cases of Hunt-Hess Ⅳ stage patients died of intraoperative bleeding or respiratory failure respectively.Postoperative fol ow-ups are without recurrence. Conclusion:Microsurgical clipping of anterior communicating artery aneurysm is safe and reliable,the ef ect is undeniable.However the indications and timing of surgery should be careful y selected.Surgical skil s such as lowering the blood pressure appropriately,clipping related arteries temporarily and end-plate ostomy,can get a superior therapeutic ef ect.