CAJ | 학술논문

目的探讨颅内外(IC-EC)动脉搭桥术治疗复杂大脑中动脉(MCA)动脉瘤的方法及疗效.方法回顾性分析北京三博脑科医院神经外科2008年5月至2012年12月手术治疗的6例复杂MCA动脉瘤的临床资料,2例采用颞浅动脉(STA)-桡动脉(RA)-MCA搭桥术加动脉瘤孤立切除术,4例采用颌内动脉(MA)-RA-MCA搭桥术加动脉瘤近心端阻断术.颅外血管吻合口采用端-端吻合,颅内血管吻合口采用端-侧吻合.结果 1例MA-RA-MCA搭桥加动脉瘤近心端阻断患者术后第3天出现偏瘫、脑疝、脑梗死,搭桥血管血栓形成,急诊行减压术及血栓取出,二次术后搭桥血管通畅.其余患者吻合口均通畅.随访3 ～58个月,恢复良好5例,生活自理1例.结论 IC-EC搭桥术加动脉瘤孤立切除或近心端阻断术可以有效地治疗复杂MCA动脉瘤.
목적 탐토로내외(IC-EC)동맥탑교술치료복잡대뇌중동맥(MCA)동맥류적방법급료효.방법 회고성분석북경삼박뇌과의원신경외과2008년5월지2012년12월수술치료적6례복잡MCA동맥류적림상자료,2례채용섭천동맥(STA)-뇨동맥(RA)-MCA탑교술가동맥류고립절제술,4례채용합내동맥(MA)-RA-MCA탑교술가동맥류근심단조단술.로외혈관문합구채용단-단문합,로내혈관문합구채용단-측문합.결과 1례MA-RA-MCA탑교가동맥류근심단조단환자술후제3천출현편탄、뇌산、뇌경사,탑교혈관혈전형성,급진행감압술급혈전취출,이차술후탑교혈관통창.기여환자문합구균통창.수방3 ～58개월,회복량호5례,생활자리1례.결론 IC-EC탑교술가동맥류고립절제혹근심단조단술가이유효지치료복잡MCA동맥류.
Objective To explore the methods and effects of intracranial-extracranial (IC-EC)vascular bypass in the treatment of complex middle cerebral artery (MCA) aneurysms.Methods 6 cases with complex MCA aneurysms were treated with operation from May 2008 to December 2012 in our department,the clinical data were analyzed retrospectively.Mter superficial temporal artery (STA)-radial artery (RA)-MCA bypass grafting was performed,the aneurysms were trapped and resected in 2 cases.After internal maxillary artery (MA)-RA-MCA bypass grafting was performed,the parent artery was occluded in 4 cases.End-to-end anastomosis was used in EC artery.End-to-side anastomosis was used in IC artery.Results Hemiparalysis,cerebral hernia and graft artery thrombosis occurred in one patient who received IMA-RA-MCA bypass the third day after operation.Decompression procedure and thrombosis removed were performed in emergency.The bridge vessel was unobstructed after second operation.All other patients kept patent.Follow-up so far,5 cases got a good result,the rest lived independent life.Conclusions IC-EC vascular bypass grafting followed by trapping aneurysm or parent artery occlusion is an effective approach in the treatment of complex MCA aneurysms.