CAJ | 학술논문

目的：探讨经小脑延髓裂入路手术夹闭小脑后下动脉远端动脉瘤的优点及显微手术技巧。方法23例手术夹闭小脑后下动脉远端动脉瘤均经后颅窝正中开颅，经小脑延髓裂入路，显微镜下夹闭小脑后下动脉远端动脉瘤。结果23例患者，共33枚动脉瘤，完全夹闭31枚，2枚切除，夹闭率94．9％。无一例手术死亡。结论经小脑延髓裂入路夹闭小脑后下动脉远端动脉瘤，不需切开小脑下蚓部，可有效的清除第四脑室血肿，降低脑压。使血管神经显示更加清楚，不损伤任何小脑组织，能最大限度地减少牵拉血管及神经组织，减少动脉瘤的术中破裂，使手术更安全。术后患者不良反应小。
목적：탐토경소뇌연수렬입로수술협폐소뇌후하동맥원단동맥류적우점급현미수술기교。방법23례수술협폐소뇌후하동맥원단동맥류균경후로와정중개로，경소뇌연수렬입로，현미경하협폐소뇌후하동맥원단동맥류。결과23례환자，공33매동맥류，완전협폐31매，2매절제，협폐솔94．9％。무일례수술사망。결론경소뇌연수렬입로협폐소뇌후하동맥원단동맥류，불수절개소뇌하인부，가유효적청제제사뇌실혈종，강저뇌압。사혈관신경현시경가청초，불손상임하소뇌조직，능최대한도지감소견랍혈관급신경조직，감소동맥류적술중파렬，사수술경안전。술후환자불량반응소。
Objective The advantages of clipping the distal posterior inferior cerebellar artery aneurysms via cerebellomedullary fissure approach and the microsurgical skills are discussed.Methods A total of 23 cases of the distal posterior inferior cerebellar artery aneurysms were clipped through cerebellomedullary fissure under the microscope.Results Among 23 cases with 33 aneurysms, 31 were totally clipped and 2 were removed, with a clipping rate of 94.9%.No operative mortality occurred.Conclusion Clipping through cerebellomedullary fissure approach can remove the hemotoma of the fourth ventricle hematoma, reduce the intracranial pressure, protect cerebellum from damage, reduce the extract of the vessels and nervous tissues to a minimum extent and the rupture of aneurysms, so the safety of surgery is improved.