前交通动脉瘤破裂手术夹闭54例临床分析

The Clinical Analysis of Craniotomy Clipping of Ruptured Anterior Communicating Artery Aneurysm in 54 Cases

目的:分析前交通动脉(Anterior Communicating Artery,ACoA)瘤破裂显微手术夹闭的临床效果。方法选取2000年1月~2013年8月来我院就诊的破裂前交通动脉瘤患者,要求手术夹闭治疗者,共54例,收集分析他们的临床资料。结果手术中有8例动脉瘤破裂出血。48例患者术后恢复良好,4例术后并发脑梗塞导致偏瘫,2例Hunt-HessⅣ级患者中,1例术中因大出血死亡,1例术后因呼吸衰竭死亡。术后随访无复发。结论显微手术夹闭前交通动脉瘤安全可靠,效果不容置疑。但应该注意选择适应症和手术时机。术中配合控制性低血压,应用临时阻断技术,进行终板造瘘等措施,可以取得更好的治疗效果。

Objective:To investigate clinical results of the microsurgery clipping of the anterior communicating artery(ACoA)aneurysm.Methods:we col ect a total of 54 cases diagnosed as ruptured anterior communicating artery aneurysm that had craniotomy clipping from January 2000 to August 2013 at our hospital,and analyze their clinical data.Results:There are 8 cases experiencing aneurysm rupture during the craniotomy.48 patients recovered wel,4 cases suf ered hemiplegia due to postoperative cerebral infarction,2 cases of Hunt-HessⅣstage patients died of intraoperative bleeding or respiratory failure respectively.Postoperative fol ow-ups are without recurrence.Conclusion:Microsurgical clipping of anterior communicating artery aneurysm is safe and reliable,the ef ect is undeniable.However the indications and timing of surgery should be careful y selected.Surgical skil s such as lowering the blood pressure appropriately,clipping related arteries temporarily and end-plate ostomy,can get a superior therapeutic ef ect.