CAJ | 학술논문

目的：探讨经硬膜外途径磨除前床突在后交通动脉动脉瘤( PCoAA)夹闭术中的应用效果。方法回顾性分析2012年1月-2014年1月开颅手术的42例PCoAA患者的临床资料,其中22例磨除前床突,20例未磨除前床突,分析术中夹闭动脉瘤难易程度及术后疗效。结果在22例磨除前床突术中,动脉瘤均得到满意夹闭,术中均未使用脑牵开器,术后仅有1例出现脑梗死,无动眼神经麻痹病例,无动脉瘤夹闭不全病例。20例未磨除前床突病例中,3例瘤夹置入困难造成动脉瘤夹闭不全,2例出现脑梗死,1例出现动眼神经麻痹。结论经硬膜外途径磨除前床突给PCoAA夹闭手术带来便利,术中能有效避免瘤夹置入困难,应用安全,降低术后并发症。
목적：탐토경경막외도경마제전상돌재후교통동맥동맥류( PCoAA)협폐술중적응용효과。방법회고성분석2012년1월-2014년1월개로수술적42례PCoAA환자적림상자료,기중22례마제전상돌,20례미마제전상돌,분석술중협폐동맥류난역정도급술후료효。결과재22례마제전상돌술중,동맥류균득도만의협폐,술중균미사용뇌견개기,술후부유1례출현뇌경사,무동안신경마비병례,무동맥류협폐불전병례。20례미마제전상돌병례중,3례류협치입곤난조성동맥류협폐불전,2례출현뇌경사,1례출현동안신경마비。결론경경막외도경마제전상돌급PCoAA협폐수술대래편리,술중능유효피면류협치입곤난,응용안전,강저술후병발증。
Objective To investigate the application effect of anterior clinoid process drilled off via epidural approach in posterior communicating artery aneurysm ( PCoAA) clipping. Methods The clinical data of 42 patients with PCoAA who underwent craniotomy from January 2012 to January 2014 were analyzed retrospectively,including 22 patients performed anterior clinoid process drilled off and 20 did not. The difficult or easy degree of intraoperative aneurysm clipping and postoperative efficacy were analyzed. Results The aneurysms in 22 patients underwent anterior clinoid process were clipped satisfactorily. The brain retractor was not used during the procedure. Only one patient had cerebral infarction after procedure. No patients had oculomotor nerve paralysis and incomplete clipping of aneurysms. Of the 20 patients without the anterior clinoid process drilled off,3 aneurysms were clipped incompletely because it was difficult to implant aneurysm clips, 2 had cerebral infarction, and 1 had oculomotor nerve paralysis. Conclusion Removing the anterior clinoid process drilled off via extradural approach may bring convenience for PCoAA clipping. It can effectively avoid the difficulty of implanting aneurysm clips during the procedure. Its application is safe and can reduce postoperative complications.