显微手术治疗颅内动脉瘤的疗效分析

The analysis of the curative effect of microsurgical treatments on intracranial aneurysms

目的探讨显微手术治疗颅内动脉瘤手术时机、手术技巧对术后疗效的影响。方法 128例首诊经CT、全脑数字减影血管造影(DSA)和(或)CT血管成像(CTA)确诊为颅内动脉瘤的患者,力争在72 h内经翼点入路开颅行显微手术夹闭动脉瘤。结果 128例中,116例全愈出院,2例死亡,10例术后放弃治疗出院(失访)。术后随访6个月～3年,恢复良好101例,轻度残疾、但生活能自理12例,中重度残疾、生活不能自理3例。结论颅内动脉瘤破裂引起急性蛛网膜下腔出血,经CT、DSA和(或)CTA确诊后应争取早期手术,CTA和术中多普勒超声等无创检查措施能为手术提供帮助。

Objective To study the influence of pre-operative conditions and microsurgical skill on the post-operative outcomes of intraeranial aneurysms,using a retrospectively analysis of 128 cases with microsurgieal treatment. Methods One hundred and twenty-eight patients with 142 intracranial aneurysms received microsurgical treatment via pterional approach. Results Of the 142 aneurysms, 130 were clipped, 1 was coated,and 3 were isolated. Of the 128 patients, 116 were cured, 10 give up therapy post- operation and 2 died. According to GOS standard, 101 eases recovered, 12 eases suffered from mild disability,3 eases suffered from moderate disability and 2 cases suffered from severe disability. Long-term follow-ups were performed in all patients. Among them,101 patients recovered well,12 patients had mild disability,2 patients had moderate disability,and 1 patient had sever disability. Conclusions Surgical clipping was the most effective method of treating intracranial aneurysm. The optimal opportunity, microsurgical technique and microanatomical knowledge were keys to successful treatment.