CAJ | 학술논문

目的：探讨后循环动脉瘤显微手术的策略及技巧。方法回顾性地分析2008年3月至2013年3月在河北医科大学第二医院实施手术治疗的21例后循环动脉瘤的临床资料及手术策略与技巧。翼点入路夹闭基底动脉瘤2例，颞下入路夹闭基底动脉瘤7例，颞下入路夹闭大脑后动脉瘤5例，枕下乙状窦后入路夹闭小脑前下动脉瘤2例，应用远外侧入路夹闭小脑后下动脉瘤3例、椎动脉瘤2例。结果所有动脉瘤均妥善夹闭。随访1～60个月，根据格拉斯哥预后评分（GOS）结果评定：良好16例（GOS 4～5分，76．2％），差3例（GOS 2～3分，14．3％），死亡2例（ GOS 1分，9．5％）。结论开颅手术是治疗后循环动脉瘤的有效手段，科学正确的手术策略、精巧细致的分离暴露方法对于手术的成功及患者的疗效至关重要。
목적：탐토후순배동맥류현미수술적책략급기교。방법회고성지분석2008년3월지2013년3월재하북의과대학제이의원실시수술치료적21례후순배동맥류적림상자료급수술책략여기교。익점입로협폐기저동맥류2례，섭하입로협폐기저동맥류7례，섭하입로협폐대뇌후동맥류5례，침하을상두후입로협폐소뇌전하동맥류2례，응용원외측입로협폐소뇌후하동맥류3례、추동맥류2례。결과소유동맥류균타선협폐。수방1～60개월，근거격랍사가예후평분（GOS）결과평정：량호16례（GOS 4～5분，76．2％），차3례（GOS 2～3분，14．3％），사망2례（ GOS 1분，9．5％）。결론개로수술시치료후순배동맥류적유효수단，과학정학적수술책략、정교세치적분리폭로방법대우수술적성공급환자적료효지관중요。
Objective To summarize surgical strategies and skills against aneurysms of posterior circulation .Methods Twenty-one cases of posterior circulation aneurysms who had undergone microsurgery between March 2008 and March 2013 were analyzed retrospectively .Two of these cases had their basilar artery aneurysms clipped via the pterion approach and five through the subtemporal approach .Five posterior cerebral artery aneurysms were clipped via the subtemporal approach , two anterior inferior cerebellar artery aneurysms were clipped via the retrosigmoid approach , three posterior inferior cerebel-lar artery aneurysms were clipped through the far lateral approach , and two vertebral artery aneurysms were clipped similar-ly approach.Results All the aneurysms were clipped successfully .According to Glasgow Outcome Scale (GOS), the cura-tive effect was poor in 3 cases(GOS 2-3 points), good in 16 cases(GOS 4-5 points) and 2 patients died(GOS 1 point). Conclusion Aneurysms of posterior circulation can be treated through microsurgery .Proper surgical strategies , operative ap-proach and delicate surgical skills are critical to the success of surgeries and curative effects .