显微手术治疗后交通动脉镜像动脉瘤的临床分析

Clinical analysis of microsurgery in treating posterior communicating artery mirror-imaging aneurysms

目的探讨后交通动脉镜像动脉瘤的显微手术治疗效果。方法回顾性分析10例后交通动脉镜像动脉瘤患者的临床资料,Hunt-Hess分级:I级1例,Ⅱ级3例,Ⅲ级5例,Ⅳ级1例。首次出血9例,未出血1例。采用一期与二期,先处理破裂动脉瘤,后处理未破裂动脉瘤的原则,显微手术夹闭后交通动脉镜像动脉瘤。结果所有动脉瘤均完全夹闭,术后经格拉斯哥(GOS)预后评分恢复良好8例,轻残1例,重残1例。术后随访1年,并发脑积水4例,行脑室-腹腔分流术后,患者恢复良好。结论显微手术夹闭后交通动脉镜像动脉瘤疗效确切,效果显著。

Objective To explore the therapeutic effect of microsurgery in treating posterior communicating artery （PCoA） mirrorimaging aneurysms. Methods The clinical materials of 10 patients with the PCoA mirror - imaging aneurysms were analyzed retrospectively. Results of Hunt - Hess grade were 1 case of Ⅱ grade, 3cases of grade Ⅱ , 5 cases of grade Ⅲ, 1case of grade Ⅳ. 9 cases had first bleeding, and 1 case had no bleeding. With the principle of I stage and Ⅱ stage, the ruptured aneurysm was processed firstly, then the unruptured aneurysm was processed. Results All the aneurysms were clipped completely. According to Glasgow Outcome Scale（GOS） scores, the prognosis of 8 cases was excellent, 1 had mild and 1 had severe disability. Patients were followed up for 1 year, and 4 patients had concurrent hydrocephalus, then they were treated by ventricular peri- toneal shunt and recovered well. Conclusion The therapeutic effect of PCoA mirror- imaging a- neurysms by microsurgical clipping was significant.