中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2014年
3期
217-220
,共4页
刘方军%石祥恩%张永力%孙玉明
劉方軍%石祥恩%張永力%孫玉明
류방군%석상은%장영력%손옥명
颅内动脉瘤%大脑中动脉%插入性血管移植%动脉瘤孤立术
顱內動脈瘤%大腦中動脈%插入性血管移植%動脈瘤孤立術
로내동맥류%대뇌중동맥%삽입성혈관이식%동맥류고립술
Intracranial aneurysm%Middle cerebral artery%Interposition graft%Trapping aneurysm
目的 探讨插入性血管移植技术在大脑中动脉(MCA)动脉瘤手术中的应用.方法 回顾性分析2008年5月至2012年10月北京三博脑科医院神经外科用插入性血管移植技术治疗7例MCA动脉瘤患者的临床资料.均取自体颞浅动脉(STA)为移植血管,5例用单干移植的方式,2例双干移植的方式.动脉瘤切除5例,孤立1例,近心端阻断1例.结果 2例术后出现病变对侧口角抽搐及一过性肢体肌力下降;1例出现一过性意识障碍,双侧动眼神经麻痹,对侧肢体偏瘫;1例术后出现颅内血肿,一过性失语,记忆力及计算力减退;经积极治疗后,除1例遗留左侧动眼神经麻痹外,其余恢复正常.均行CTA检查,6例显示移植血管通畅,吻合口无狭窄,1例移植血管显示不清,但是远端血管显影良好.3例行DSA检查,移植血管均通畅,动脉瘤不显影,吻合口无狭窄.随访12～65个月,GOS评分5分6例,4分1例.结论 插入性血管移植可以有效的治疗不能进行夹闭手术的MCA动脉瘤.
目的 探討插入性血管移植技術在大腦中動脈(MCA)動脈瘤手術中的應用.方法 迴顧性分析2008年5月至2012年10月北京三博腦科醫院神經外科用插入性血管移植技術治療7例MCA動脈瘤患者的臨床資料.均取自體顳淺動脈(STA)為移植血管,5例用單榦移植的方式,2例雙榦移植的方式.動脈瘤切除5例,孤立1例,近心耑阻斷1例.結果 2例術後齣現病變對側口角抽搐及一過性肢體肌力下降;1例齣現一過性意識障礙,雙側動眼神經痳痺,對側肢體偏癱;1例術後齣現顱內血腫,一過性失語,記憶力及計算力減退;經積極治療後,除1例遺留左側動眼神經痳痺外,其餘恢複正常.均行CTA檢查,6例顯示移植血管通暢,吻閤口無狹窄,1例移植血管顯示不清,但是遠耑血管顯影良好.3例行DSA檢查,移植血管均通暢,動脈瘤不顯影,吻閤口無狹窄.隨訪12～65箇月,GOS評分5分6例,4分1例.結論 插入性血管移植可以有效的治療不能進行夾閉手術的MCA動脈瘤.
목적 탐토삽입성혈관이식기술재대뇌중동맥(MCA)동맥류수술중적응용.방법 회고성분석2008년5월지2012년10월북경삼박뇌과의원신경외과용삽입성혈관이식기술치료7례MCA동맥류환자적림상자료.균취자체섭천동맥(STA)위이식혈관,5례용단간이식적방식,2례쌍간이식적방식.동맥류절제5례,고립1례,근심단조단1례.결과 2례술후출현병변대측구각추휵급일과성지체기력하강;1례출현일과성의식장애,쌍측동안신경마비,대측지체편탄;1례술후출현로내혈종,일과성실어,기억력급계산력감퇴;경적겁치료후,제1례유류좌측동안신경마비외,기여회복정상.균행CTA검사,6례현시이식혈관통창,문합구무협착,1례이식혈관현시불청,단시원단혈관현영량호.3례행DSA검사,이식혈관균통창,동맥류불현영,문합구무협착.수방12～65개월,GOS평분5분6례,4분1례.결론 삽입성혈관이식가이유효적치료불능진행협폐수술적MCA동맥류.
Objective To investigate the efficacy of interposition graft technique in the treatment of cerebral artery (MCA) aneurysms.Methods The clinical data of 7 patients with MCA aneurysm treated by interposition graft technique from May 2008 to October 2012 were analyzed retrospectively.The superficial temporal artery (STA) was selected as donate blood vessel.Single vessel graft was performed in five cases and double vessels graft in two.After the bypass procedure was successfully performed,the aneurysms were removed in 5 cases,trapped in one,and left alone and parent artery occluded in one.Results Temporary mouth angle convulsion and transient decline in contralateral limbs muscle strength were detected in 2 cases.Coma,bilateral oculomotor nerve palsy and contralateral hemiplegia were detected in 1 case.Postoperative intracranial hematoma,transient aphasia,memory and calculation ability loss were detected in 1 case.One patient left the left oculomotor nerve palsy after treatment,and the others were returned to normal.Confirmed by CTA,graft vessel was unobstructed in 6 patients,showed unclear in 1 patient but the distal arteries were developing well.DSA examination was performed in 3 patients,there was no narrowness in the bypass vessels and anastomosis and the aneurysms were undeveloped.Six cases scored 5 and 1 case scored 4 during the follow-up period (12 ～ 65 months) according to Glasgow outcome score.Conclusions Interposition artery bypass was an effective way for the treatment of unclippable MCA aneurysms.
