中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2015年
5期
458-460
,共3页
大脑中动脉%颅内动脉瘤%显微外科手术%大脑梗塞%脑血管造影术%分类
大腦中動脈%顱內動脈瘤%顯微外科手術%大腦梗塞%腦血管造影術%分類
대뇌중동맥%로내동맥류%현미외과수술%대뇌경새%뇌혈관조영술%분류
Middle cerebral artery%Intracranial aneurysm%Microsurgery%Cerebral infarction%Cerebral angiography%Classification
目的 探讨根据大脑中动脉动脉瘤(MCAA)的影像学分型,术中识别并保护外侧纹体动脉(LLA)对预防脑梗死的指导意义.方法 回顾性分析2006年12月至2013年6月收治74例,共89个大脑中动脉动脉瘤,依据影像学资料分为A型(前外侧型)52个,B型(后上型)28个和C型(内下型)9个.采用不同的分离技巧,术中皆成功分辨并保护LLA,动脉瘤夹闭86个,微动脉瘤电凝后包裹3个.随访按格拉斯哥预后评分(GOS)标准进行评分.结果 GOS 5分(治愈)66例,4分(轻偏瘫但自理)5例,3分(重残)2例,1分(死亡)1例.结论 依据动脉瘤影像学分型,采用个体化手术分离技巧,结合LLA的解剖特点,术中识别并保护LLA和夹闭动脉瘤,减少术后脑梗死的发生率.
目的 探討根據大腦中動脈動脈瘤(MCAA)的影像學分型,術中識彆併保護外側紋體動脈(LLA)對預防腦梗死的指導意義.方法 迴顧性分析2006年12月至2013年6月收治74例,共89箇大腦中動脈動脈瘤,依據影像學資料分為A型(前外側型)52箇,B型(後上型)28箇和C型(內下型)9箇.採用不同的分離技巧,術中皆成功分辨併保護LLA,動脈瘤夾閉86箇,微動脈瘤電凝後包裹3箇.隨訪按格拉斯哥預後評分(GOS)標準進行評分.結果 GOS 5分(治愈)66例,4分(輕偏癱但自理)5例,3分(重殘)2例,1分(死亡)1例.結論 依據動脈瘤影像學分型,採用箇體化手術分離技巧,結閤LLA的解剖特點,術中識彆併保護LLA和夾閉動脈瘤,減少術後腦梗死的髮生率.
목적 탐토근거대뇌중동맥동맥류(MCAA)적영상학분형,술중식별병보호외측문체동맥(LLA)대예방뇌경사적지도의의.방법 회고성분석2006년12월지2013년6월수치74례,공89개대뇌중동맥동맥류,의거영상학자료분위A형(전외측형)52개,B형(후상형)28개화C형(내하형)9개.채용불동적분리기교,술중개성공분변병보호LLA,동맥류협폐86개,미동맥류전응후포과3개.수방안격랍사가예후평분(GOS)표준진행평분.결과 GOS 5분(치유)66례,4분(경편탄단자리)5례,3분(중잔)2례,1분(사망)1례.결론 의거동맥류영상학분형,채용개체화수술분리기교,결합LLA적해부특점,술중식별병보호LLA화협폐동맥류,감소술후뇌경사적발생솔.
Objecfive To evaluate the value of imaging classification of middle cerebral artery aneurysm on prevention of cerebral infarction during operation.Methods A total of 87 cases with 89 aneurysms were classified into 3 types according to the angiographical projections:type A with anterior-lateral projection in 52 aneurysms,type B with superior-posterior projection in 28 aneurysms and type C with inferior projection in 9 aneurysms.Eighty-six aneurysms were clipped,while the other 3 micro-aneurysms were coagulated and wrapped.All the lateral lenticulostriate arteries were well identified and protected.Results According to Glasgow outcome score,66 cases were 5,5 cases were 4,2 cases were 3 and 1 case was 1.Conclusion It was easier to identify and protect the lateral lenticulostriate artery and reduce the incidence of postoperative cerebral infarction by the guidance of preoperative imaging classification combined with the acknowledgement of the recurrent course of lateral lenticulostriate artery.
