CAJ | 학술논문

目的探讨经眶外侧微骨孔入路夹闭破裂的微小动脉瘤的临床经验和手术技巧.方法 2013年1月至2015年4月我们采用眶外侧锁孔入路显微手术治疗破裂的微小动脉瘤患者56例,回顾性分析其检查方法、影像学特征、诊治过程及手术效果.结果经CT血管造影(CTA)和/或数字减影血管造影(DSA)检查确诊61个动脉瘤,其中微小动脉瘤56个,均成功夹闭动脉瘤瘤颈,术中破裂13例;术后恢复良好42例,生活能自理8例,扶拐行走、需人照顾6例.其中49例随访2～ 28个月,均无再出血发生,无一例死亡.结论眶外侧锁孔入路显微手术治疗微小动脉瘤具有简捷、快速、微创的优点,手术时机的正确选择、完善的显微解剖及术中精湛的微侵袭操作技术对于顺利夹闭破裂的微小型动脉瘤、预防和控制术中破裂出血尤为重要.
목적 탐토경광외측미골공입로협폐파렬적미소동맥류적림상경험화수술기교.방법 2013년1월지2015년4월아문채용광외측쇄공입로현미수술치료파렬적미소동맥류환자56례,회고성분석기검사방법、영상학특정、진치과정급수술효과.결과 경CT혈관조영(CTA)화/혹수자감영혈관조영(DSA)검사학진61개동맥류,기중미소동맥류56개,균성공협폐동맥류류경,술중파렬13례;술후회복량호42례,생활능자리8례,부괴행주、수인조고6례.기중49례수방2～ 28개월,균무재출혈발생,무일례사망.결론 광외측쇄공입로현미수술치료미소동맥류구유간첩、쾌속、미창적우점,수술시궤적정학선택、완선적현미해부급술중정담적미침습조작기술대우순리협폐파렬적미소형동맥류、예방화공제술중파렬출혈우위중요.
Objective To investigate the clinical application and surgical techniques of lateral-orbital keyhole approach to clip ruptured tiny aneurysms.Methods A retrospective analysis was performed on the clinical data of 56 patients with ruptured tiny aneurysms, including examination methods, imaging features, diagnosis and treatment process, and operation effect, which underwent lateral-orbital keyhole approach from January 2013 to April 2014.Results Among 56 patients with a total of 61 aneurysms(56 tiny aneurysms) was examined by CT angiography (CTA) and/or digital stubtraction angiography (DSA), all achieved successful clipping with a rupture rate of 16％(13 cases).Forty-two cases got a good recovery,8 cases owned the self-care ability, and 6 cases could carry out daily lives with help.There was no rebleeding and mortality, according to a 2-28 months' follow-up of 49 patients.Conclusion As a surgical approach for Willi'S cycle aneurysm,the lateralorbital approach is simple,rapid,minimally-invasive way.It is available in the clipping of ruptured tiny anterior communicating aneurysms.The option of operative time, perfect microdissection and exquisite intraoperative microinvasive operative skills, will be the key point of clipping aneurysms, preventing and controlling of intraoperative bleeding.