神经内镜结合显微外科技术治疗颅内前循环动脉瘤

Neuroendoscope and microsurgery for treatment of intracranial aneurysms of anterior circulation

目的探讨应用神经内镜结合显微外科技术治疗颅内前循环动脉瘤的疗效。方法应用神经内镜结合显微外科手术治疗15例单发颅内前循环动脉瘤。在神经内镜下观察动脉瘤、载瘤动脉、动脉瘤夹及其毗邻结构的解剖学特征。手术前后均做全脑血管造影术(DSA)评估动脉瘤夹闭情况。结果 15例颅内前循环动脉瘤均采用神经内镜结合显微镜的手术方式顺利夹闭。术后复查DSA显示动脉瘤夹闭完全、无误夹和漏夹。术后出现短暂的动眼神经麻痹和视力下降各1例,本组无死亡。结论神经内镜结合显微神经外科技术为颅内动脉瘤的外科治疗提供了新手段,术中可提供更多有价值的信息,提升手术疗效,降低术后并发症,具有重要的临床应用价值。

Objective To explore the role of neuroendoscope and microsurgery for treatment of intracranial aneurysms of anterior circulation. Method 15 patients with single intracranial aneurysms of anterior circulation were treated by neuro-endoscope and microsurgery through keyhole pterion approach. Using endoscope,operative doctors can observe all directions and surrounding structures of aneurysm before, during and after the clipping intracranial aneurysm. Doctors can evaluate the effect of the clipping with digital subtraction angiography（DSA）. Result 15 aneurysms of anterior circulation was clipped successfully with neuroendoscope and microsurgery. DSA showed that the effect of the clipping of intracranial aneurysms was satisfied. One patient had transitory oculomotor paralysis and the other pa-tient had transitory impaired vision after operation. No intraoperative and perioperative mortality. Conclusion The technique of neuroendoscope and microsurgery create a new method for the clipping of intracranial aneurysms. Neu-roendocope can provide more important intraoperative information for microsurgery,thus enhancing curative effect of operation and reducing complications. The worth of clinical application is very important.