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1、显微镜下经翼点入路手术治疗前循环动脉瘤临床分析【摘要】目的:通过分析前循环动脉瘤的显微手术治疗,探讨手术入路与技巧、避免术中动脉瘤破裂及破裂后处理以及脑血管痉挛的预防和处理。方法:回顾分析2011年3月-2015年6月笔者所在科室收治的48例前循环动脉瘤的显微手术治疗患者的临床资料。结果:手术成功率为100%,大面积脑樓死3例,基底节小面积樓死1例,单肢瘫2例,动眼神经麻痹1例,死亡2例。术后随诊2~12个月,术后恢复良好39例,轻残6例,重残2例,死亡2例。木组近期疗效良好率81.25%(39/48),病死率4.16%(2
2、/48)o结论:经翼点入路手术夹闭是治疗前循坏颅内动脉瘤的有效方法,避免动脉瘤破裂和止确处理术中破裂出血,积极防治脑血管痉挛是手术成功的关键。【关键词】前循环动脉瘤;经翼点入路;显微外科手术屮图分类号R651.1文献标识码B文章编号1674-6805(2016)4-0013-03ClinicalAnalysisofUndertheMicroscopeViaPterionalApproachinSurgicalTreatmentofAnteriorCirculationAneurysms/GAOYong-feng,ZHUJun
3、一wu,YAOJun-heng,etal.//ChineseandForeignMedicalResearch,2016,14(4):13-15【Abstract]Objective:Throughtheanalysisofanteriorcirculationaneurysmsmicrosurgicaltreatment,toexplorethesurgicalapproachandskills,toavoidintraoperativeaneurysmruptureandrupturepostprocessingandc
4、erebralvasospasmpreventionandtreatment.Method:Theclinicaldataof48casesofanteriorcirculationaneurysmstreatedbymicrosurgeryinourdepartmentfromMarch2011toJune2015wereanalyzedretrospectively.Result:Theoperationsuccessratewas100%,3casesoflargeareacerebralinfarction,1cas
5、eofbasalgangliainfaretionareawassmall,singlelimbparalysisin2cases,1caseofoculomotornervepalsy,death2cases.Afteroperationwithfollow-upof2to12months,thepostoperativerecoverygoodin39cases,milddisabilityin6cases,2casesofseveredisability,death2cases.Theshort-termefficac
6、yofthisgroupwas81.25%(39/48),themortalityratewas4.16%(2/48).Conclusion:Thepterionalapproachc1ampclosebeforetreatmentcirculationintracranialaneurysmsofreliableandeffectivemethod,avoidaneurysmruptureandpropertreatmentofintraoperativebleeding,activepreventionandtreatm
7、entofcerebralvasospasmiskeytothesuccessoftheoperation.【Keywords】Anteriorcirculation且neurysm;Pterionalapproach;MicrosurgicaloperationFirst-author"saddress:XiangchengCountyPeople"sHospital,Xiangcheng461700,Chinadoi:10.14033/j.cnki.cfmr.2016.4.007颅内动脉瘤破裂是蛛网膜下腔出血最常见的原因
8、,颅内动脉瘤破裂出血致残率、死亡率非常高,是危害人类健康既常见又严重的疾病,也是神经外科最常见的脑血管疾病[1-2]o目前随着手术器材的发展和显微神经外科技术的提高,许多学者提出早期手术对改善患者预后起到了积极的作用,早期手术取得了较好的效果。笔者所在医院自2010年购买神经外科专用显微镜