大脑中动脉分叉部动脉瘤并发脑内血肿的显微手术治疗体会

Experience of microsurgical operation on aneurysms in furcation of middle cerebral artery combined with intracerebral hematoma

目的 探讨大脑中动脉分叉部动脉瘤并发脑内血肿患者的显微手术治疗技巧.方法 回顾性分析2007-01-2012-01来我院治疗的大脑中动脉分叉部动脉瘤并发脑内血肿患者36例,均进行显微手术治疗,并随访8～12个月,平均（10.3±0.3）个月,观察患者术后结局、并发症情况及预后.结果 36例患者中,动脉瘤夹闭29例,动脉瘤夹闭结合包裹处理6例,仅单侧动脉瘤夹闭处理1例;随访结果：癫（癎）1例,失语4例,偏瘫8例;根据哥斯拉量表评分,重度残疾4例,中度残疾5例,恢复良好27例.结论 大脑中动脉分叉部动脉瘤合并脑内血肿患者行显微外科手术治疗临床疗效显著.

Objective To explore clinical effects of mierosurgical operation on aneurysms in bifurcation of middle cerebral artery combined with intraeerebral hematoma. Methods From January 2007 to January 2012, 36 eases of patients with aneu rysms in bifurcation of middle cerebral artery combined with intracerebral hematoma in our hospital were reviewed and ana- lyzed, who were all treated with the microsurgical operation and followed up. The follow-up time was 84 12 months, with 10.3 ± 0.3 months on average. The results after operation, complications and prognosis of long-term according to the scale of Godzilla were analyzed. Results Among these 36 patients, 29 cases were clipping aneurysm, 6 cases were clipping aneurysm combined package processing; 1 case with unilateral only aneurysm clipping treatment. In the long term follow up we found 1 case with epilepsy, 4 cases with aphasia, and 8 cases with hemiplegia. According to the outcomes of the Godzilla scale, 4 cases of severe disability, 5 cases of moderate disability, and 27 cases of good recovery. Conclusion It has obvious clinical effects for microsurgical operation on treat aneurysms in bifurcation of middle cerebral artery combined with intracerebral hematoma.