摘要
本文报告113例脑前循环系统动脉管其中包括颈内动脉后交通动脉瘤75例.前交通动脉瘤17例,大脑中动脉瘤10例,人脑前动脉-胼周动脉瘤3例,颈内动脉-眼动脉瘤2例,颈内动脉海绵窦段动脉瘤1例.多发动脉瘤5例.共118个动脉瘤在显微镜下直视手术,动脉瘤直接夹闭术108例.孤立或包裹术5例:5例多发动脉瘤行同期手术3例,分期手术2例.术中发生动脉瘤破裂18次.Hunt和HessⅠ～Ⅱ级病人中有例行早期手术.全组术后死亡率为7.9%.着重讨论手术时机.术中动脉瘤破裂处理及多发动脉瘤的治疗.
One hundred and thirteen cases of anterior circulation aneurysms treated by microsur-gical operation were reported, which included 75 ICA-PCoA aneurysms, 17 ACoA aneurysms, 10 MCA aneurysms, 3 ACA aneurysms, 2 ICA-OPhA aneurysms,1 intracavernous carotid artery aneurysm, and 5 multiple aneurysms (2 a-neurysms each). All the aneurysms were treated microsurgically:clipping of neck in 108, trapping or wrapping in 5, and the 5 cases of multiple a-neurysms were operated by one or two staged op-erations. Intraoperative aneurysm rupture oc-cured in 18 cases. 2 patients of Hunt and Hess grade Ⅰ - Ⅱ were treated early within 48 hours after initial bleeding. The timing of operation, management of intraoperative rupture of a-neurysm and the treatment of multiple a-neurysms were discussed.
