CAJ | 학술논문

目的探讨床突旁颈内动脉动脉瘤的外科治疗方法.方法回顾性分析67例71个床突旁颈内动脉动脉瘤的临床资料.结果 67例患者共71个床突旁动脉瘤.同侧或对侧改良翼点入路直接手术夹闭42例；5例采用颅内外血管搭桥+动脉瘤孤立术；9例采用血管内介入治疗；11例海绵窦段动脉瘤未采取任何治疗措施.在56例治疗病例中,KPS评分90分以上有49例,80分者6例,70分者1例,无死亡、重残者.结论床突旁颈内动脉动脉瘤手术直接夹闭预后良好.对于复杂、巨大动脉瘤或海绵窦内动脉瘤,血管搭桥手术是必要的治疗手段之一.
목적 탐토상돌방경내동맥동맥류적외과치료방법.방법 회고성분석67례71개상돌방경내동맥동맥류적림상자료.결과 67례환자공71개상돌방동맥류.동측혹대측개량익점입로직접수술협폐42례；5례채용로내외혈관탑교+동맥류고립술；9례채용혈관내개입치료；11례해면두단동맥류미채취임하치료조시.재56례치료병례중,KPS평분90분이상유49례,80분자6례,70분자1례,무사망、중잔자.결론 상돌방경내동맥동맥류수술직접협폐예후량호.대우복잡、거대동맥류혹해면두내동맥류,혈관탑교수술시필요적치료수단지일.
Objective To explore the surgical strategies in the management of clinoid and paraclinoid aneurysms.Methods The clinical data of 67 patients with 71 clinoid and paraclinoid aneurysms,that received surgical treatment between June 2005 and June 2010,were analyzed retrospectively.Results The 67 patients had 71 clinoid and paraclinoid aneurysms,including 22 large-type and 10 giant-type ones.Of the 71 clinoid and paraclinoid aneurysms,42 were managed by direct surgical clipping via modified ipsilateral or contralateral transpterional approach,5 by extracranial-intracranial bypass + aneurysm trapping,and 9 by endovascular coiling,including 8 cavernous sinus aneurysms.The other 11 cavernous sinus aneurysms did not receive any treatment.During the follow-up period,it was found that the KPS score was over 90 in 49 cases,80 in 6 cases,and 70 in one case in the 56 treated cases.There was no severe disability and death.Conclusions The prognosis of the direct surgical clipping of clinoid and paraclinoid aneurysms is good.Bypass may be a necessary option for the treatment of some complex giant aneurysms or cavernous sinus aneurysms.