基层医院开展显微手术治疗颅内动脉瘤的临床经验

CLINICAL EXPERIENCE OF MICROSURGERY FOR INTRACRANIAL ANEURYSM AT PRIMARY LEVEL HOSPITALS

目的总结基层医院开展颅内动脉瘤显微外科手术的经验。方法回顾分析了近3年对高血压性脑出血和慢性硬膜下积液病人侧裂及鞍区的显微解剖资料及颅内动脉瘤治疗的资料。结果通过鞍区及侧裂显微手术实践,基本掌握了鞍区解剖知识和侧裂分离技术。39例颅内动脉瘤病人中,25例恢复正常工作,9例轻残,2例重残需人照料,术后死亡3例(占7.6%)。术后脑积水4例。结论熟悉鞍区显微解剖知识和侧裂分离技术对于基层医院开展颅内动脉瘤显微外科手术是非常重要的。

Objective To summarize the experience of doing microsurgery for intracranial aneurysm at primary level hospitals. Methods The clinical data of hypertensive intracerebral hemorrhage （HICH） and microanatomy in Sella region and sylvian fissures in patients with chronic subdural effusion as well as the treatment of intracranial aneurysm in the last three years were analyzed retrospectively. Results The knowledge of microanatomy in the Sella and dissection techniques in sylvian fissures were obtained through microsurgical practice. Of 39 patients with intracranial aneurysm treated, 25 returned to normal work, nine were mild disability, two severe disability. Three died after operation. Postoperative hydrocephalus occurred in four. Conclusion Having an intimate knowledge of microanatomy in the Sella and skill of dissection of sylvian fissures is crucial to carrying out microsurgery for intracranial aneurysm at grass-roots hospitals.