本文選題：顱內(nèi)動(dòng)脈瘤　切入點(diǎn)：大腦中動(dòng)脈　出處：《重慶醫(yī)科大學(xué)學(xué)報(bào)》2015年01期 　論文類型：期刊論文

【摘要】：目的:總結(jié)顯微外科手術(shù)夾閉大腦中動(dòng)脈分叉處動(dòng)脈瘤的臨床經(jīng)驗(yàn)和體會(huì)。方法:回顧性分析28例經(jīng)顯微外科手術(shù)治療的大腦中動(dòng)脈分叉處動(dòng)脈瘤患者的臨床資料、手術(shù)過程,總結(jié)經(jīng)驗(yàn)。結(jié)果:28例患者共30個(gè)動(dòng)脈瘤,其中5例伴有腦內(nèi)血腫;根據(jù)計(jì)算機(jī)斷層血管造影(computed tomography angiography,CTA)或數(shù)字減影血管造影(digital subtraction angiography,DSA)評估動(dòng)脈瘤的大小、形態(tài)、朝向和與分叉血管的關(guān)系,精心設(shè)計(jì)顯微手術(shù);術(shù)后隨訪6~12月,格拉斯哥預(yù)后分級(jí)(Glasgow outcome scale,GOS)評分優(yōu)良22例,中殘4例,重殘1例,植物生存狀態(tài)1例。結(jié)論:對于大腦中動(dòng)脈分叉處動(dòng)脈瘤,應(yīng)及早手術(shù),術(shù)前影像學(xué)上的準(zhǔn)確分析與評估、合適的手術(shù)入路、嫻熟的手術(shù)技巧是有效夾閉大腦中動(dòng)脈分叉處動(dòng)脈瘤,提高術(shù)后療效的關(guān)鍵。
[Abstract]:Objective: to summarize the clinical experience and experience in microsurgical clipping of aneurysms at the middle cerebral artery bifurcation. Methods: the clinical data and surgical process of 28 patients with microsurgical treatment of aneurysms at the middle cerebral artery bifurcation were analyzed retrospectively. Results there were 30 aneurysms in 28 patients, 5 of which were accompanied by intracerebral hematoma. The size and morphology of aneurysms were evaluated according to computed tomography angiography or digital subtraction angiography. The relationship between orientation and bifurcation vessels was carefully designed for microsurgery, Glasgow outcome scale score was excellent in 22 cases, moderate disability in 4 cases, severe disability in 1 case, and follow-up from 6 to December, Glasgow outcome scale scale score was good in 22 cases, 4 cases with moderate disability and 1 case with severe disability. Conclusion: for aneurysms of middle cerebral artery bifurcation, early operation, accurate analysis and evaluation of preoperative imaging, and appropriate approach should be made. Skillful surgical techniques are the key to the effective clipping of aneurysms at the middle cerebral artery bifurcation and the improvement of postoperative efficacy.
【作者單位】： 重慶醫(yī)科大學(xué)附屬第二醫(yī)院神經(jīng)外科;
【分類號(hào)】：R651.12

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