基层医院后交通动脉瘤的显微手术治疗

Microsurgery for Posterior Communicating Artery Aneurysms

目的总结基层医院开展后交通动脉瘤的显微手术治疗经验。方法回顾分析2008年1月-2012年12月48例行后交通动脉瘤显微手术治疗患者的临床资料，将48例患者按时间先后分为两组，其中2008年1月-2011年9月手术24例，2011年9月-2012年12月手术24例，比较两组手术效果。结果48例患者瘤颈均成功夹闭，出院时按格拉斯哥预后评分（GOS），治疗结果好（GOS4～5分）38例（79．2％），差（GOS2～3分）7例（14．6％），死亡（GOS1分）3例（6．3％），开展此类手术后，手术时间缩短，动脉瘤术中破裂率降低，术后并发症发生率下降，患者平均住院费用降低，前后24例比较差异有统计学意义（P〈0．05）。结论显微手术是治疗后交通动脉瘤的理想方法，适宜在基层医院开展。

Objective To summarize the experience of microsurgery in primary hospital for the posterior communicating artery aneurysms （PCOAan）. Methods The clinical data of 48 patients with PCOAan who underwent microsurgery from January 2008 to December 2012 were retrospectively analyzed. Results All the necks of aneurysms of 48 cases were successfully clipped, Acording to the Glasgow outcome score （GOS）, the early curative effects were good in 36 cases （75.0%, GOS 4-5） poor in 10 cases （20.8%, GOS 2-3） and death in 3 cases （2.1%, GOS 1）. After the operation was carried out, the operation time was shorten, aneurysm intraoperative rupture rate was lower, postoperative complications were lower, and the average medical expense was reduced; the difference was significant in 24 cases before and after the operation （P 〈 0.05）. Conclusion Microsurgery for PCOAan is an effective method which should be popularized in primary hospitals.