CAJ | 학술논문

目的：总结经翼点入路显微外科手术夹闭破裂前交通动脉瘤的临床经验。方法：回顾性分析我院2008年7月-2013年7月行经翼点入路显微手术治疗的53例破裂前交通动脉瘤患者的影像学资料、诊疗经过、并发症、预后等。结果：早期手术（3d内）10例，中期手术（4-14d）31例，延期手术(大于14d）12例。手术效果按GOS评定(出院时)，恢复良好36例（67.9%），中残7例（13.2%）重残6例（11.3%）死亡4例（7.5%）。结论：经翼点入路显微手术治疗前交通动脉瘤疗效确切，术前充分准备及正确评估，选择正确手术时机，术中对颅内压控制、对动脉瘤破裂出血正确处理、娴熟的显微手术技术以及熟练掌握局部显微解剖是保证手术成功的关键。
목적：총결경익점입로현미외과수술협폐파렬전교통동맥류적림상경험。방법：회고성분석아원2008년7월-2013년7월행경익점입로현미수술치료적53례파렬전교통동맥류환자적영상학자료、진료경과、병발증、예후등。결과：조기수술（3d내）10례，중기수술（4-14d）31례，연기수술(대우14d）12례。수술효과안GOS평정(출원시)，회복량호36례（67.9%），중잔7례（13.2%）중잔6례（11.3%）사망4례（7.5%）。결론：경익점입로현미수술치료전교통동맥류료효학절，술전충분준비급정학평고，선택정학수술시궤，술중대로내압공제、대동맥류파렬출혈정학처리、한숙적현미수술기술이급숙련장악국부현미해부시보증수술성공적관건。
Objective:To summarize the clinical experience of microscopic surgical treatment in patients with anterior communicating artery aneurysm.Methods:The clinical data of 53 patients with ruptured anterior communicating artery aneurysm, admitted to our hospital from July 2008 to July 2013 and performed microneurosurgical treatment via pterional approch, were retrospective analyzed;their clinical and imaging data, treatment,complications and efifcacy were concluded.Results:10 patients received early operation,31 patients received middle operation, 12 patients were delayed. Operation effect was evaluated by GOS (discharge), 36 (67.9%)patients were discharged in good condition,7(13.2%) patients suffered from moderate disability,6(11.3%) from severe disability and 4 (7.5%)died.Conclusion:The treatment of ruptured anterior communicating artery aneurysms treated with microsurgery via pterional approach is accurate, the key to guarantee the successful operation is sufifcient preoperative preparation and correct evaluation, choosing the right operation time, intraoperative on intracranial pressure control、correctly treatment to the bleeding rupture of aneurysm、skilled microsurgery technology and mastering the local anatomy.