眼动脉段颈内动脉瘤的显微外科治疗

Microsurgical treatment of the carotid ophthalmic aneurysms

目的探讨眼动脉段颈内动脉瘤的显微手术适应证,手术技巧和预后。方法采用硬膜内-外入路显微手术夹闭眼动脉段颈内动脉瘤12例,共13个动脉瘤。结果本组患者术后经CTA或血管造影复查,证实动脉瘤已完全夹闭。视力障碍1例,术后视力有改善,2例视野缺损者术后均有好转,2例术后出现暂时性动眼神经麻痹,1例术后出现对侧肢体轻偏瘫,考虑术后脑血管痉挛脑梗塞所致。术后随访4～12个月,平均6个月,恢复良好。结论显微外科手术治疗眼动脉段颈内动脉瘤是安全可靠的治疗方法。

Objective To explore the microsurgical indication, surgical skill and prognosis of the carotid ophthalmic aneurysms. Methods 12 cases with 13 carotid-ophthalmic aneurysms were cured with the direct microsurgical clipping. Results All aneurysms were occluded and later confirmed by CTA or angiography, and no operative death occurred . After operation, 1 case of visual capacity and 2 cases of visual field defect were improved, 2 cases occurred temporary oculomotor palsy and 1 case occurred hemiparesis of opposite side member, which was considered to cerbral infarction caused by cerebral angio spasm. All patients were followed up for 4 to 12 months （average 6 months）, and gained good recovery. Conclusion Microsurgical treatment for the carotid ophthalmic aneurysms is safe and effective.