经翼点入路显微手术治疗颅内前循环动脉瘤

Microneurosurgical Treatment of Intracranial Aneurysms of Carotid Circulation through Transpterional Approach

目的探讨经翼点入路显微手术治疗颅内前循环动脉瘤的时机,手术原则及手术技巧。方法回顾分析应用翼点入路对78例,82个颅内前循环动脉瘤进行的显微手术及其疗效。结果动脉瘤直接夹闭80个,孤立1个巨大眼动脉瘤,包裹1个复杂的前交通动脉瘤。78例患者治愈60例(77.0%),轻残10例(12.8%),重残5例(6.4%),死亡3例(3.8%)。结论颅内动脉瘤破裂导致蛛网膜下腔出血(SAH),一经确诊且病情允许应争取早期手术。经翼点入路采用显微外科技术是治疗颅内前循环动脉瘤安全、有效的方法。

Objective To evaluate the time, principle and skill of microsurgical treatment for intracranial aneurysms of anterior circulation. Methods Data of 84 intracranial aneurysms （78 patients） undergoing microneurosurgical operation through transpterional approach were analyzed retrospectively. Results Eighty aneurysms were directly clipped. One giant ophthalmic artery aneurysm was isolated. One complicated anterior communicating artery aneurysm was wrapped. of the 78 cases, 60 （77.0 %） were cured, 10 （12.8%） were significantly improved with minor neurologic.deficits, 5 （6. 4%） had major neurologic deficits and 3 patients died （3.8% ）. Conclusion Once the patients with ~AH were diagnosed as having ruptured aneurysm, surgical measure should be taken early. Skillful microneurosurgery by transpterional approach is an effective and safe therapeutic option in the treatment of the inrtacranial aneurysm of anterior circulation.