颅内前循环动脉瘤的显微外科手术治疗

Microsurgical treatment in aneurysms of anterior circulation

目的探讨颅内前循环动脉瘤显微外科手术治疗方法，总结前循环动脉瘤治疗的相关经验。方法回顾性分析近2年来显微外科治疗Ⅰ～Ⅳ级颅内前循环动脉瘤171例（共174个动脉瘤）的临床资料，以及不同部位动脉瘤的手术技巧及治疗经验。结果Ⅰ～Ⅳ级颅内前循环动脉瘤171例，其中后交通动脉瘤67例，前交通动脉瘤56例，大脑中动脉瘤32例，颈内动脉分叉部动脉瘤10例，眼动脉瘤6例，多发动脉瘤3例。均成功进行了手术夹闭，术后GOS评分预后分级Ⅰ级3例，Ⅲ级6例，Ⅳ级14例．Ⅴ级148例。结论良好的显露及显微外科技术是成功夹闭动脉瘤的关键；术中预判、动脉瘤夹合理的选择、载瘤动脉的正确阻断是值得重视的影响手术成败的因素。

Objective To summarize the method and experience of microsurgical treatment of intracranial aneurysms in antetior circulation. Methods The clinical data, the skills and experience of 171 eases with aneurysmso of anterior circulation within the latest 2 years. Results One hundred and seventy-one patients under surgery, including 67 PCOA aneurysm, 56 ACoA aneurysm, 32 MCA aneurysm, 10 ICA aneurysm, OphA aneurysm and 3 hairness aneurysm. Accoring to Glasgow Prognostic Scale, there were 3 cases of grade Ⅰ, 6 cases of grade Ⅲ, 14 cases of grade Ⅳ and 148 cases of grade Ⅴ. Conclusion The key points to cure intracranial aneurysms successfully is favourable exposure and the skills of microsurgery; the factors of influent surgery include forcejudgement in surgery, reasonable choice of aneurysm clips, correctly block in arterious.