資源描述：
《顱內(nèi)巨大動(dòng)脈瘤的手術(shù)治療》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在行業(yè)資料-天天文庫。
1、·1214·南方醫(yī)科大學(xué)學(xué)報(bào)（JSouthMedUniv）2012;32(8)臨床研究顱內(nèi)巨大動(dòng)脈瘤的手術(shù)治療122黃理金，馮文峰，漆松濤12南方醫(yī)科大學(xué)第三附屬醫(yī)院神經(jīng)外科、介入科，廣東廣州，510630；南方醫(yī)院神經(jīng)外科，廣東廣州510515摘要：目的探討顱內(nèi)巨大動(dòng)脈瘤的手術(shù)時(shí)機(jī)、手術(shù)方法及療效。方法回顧性分析2001年1月~2010年1月南方醫(yī)院神經(jīng)外科治療的15例顱內(nèi)巨大動(dòng)脈瘤。動(dòng)脈瘤夾夾閉8例；動(dòng)脈瘤孤立并顱內(nèi)-顱外血管架橋術(shù)1例；大隱靜脈移植顱內(nèi)-顱外血管架橋并載瘤動(dòng)脈閉塞3例；瘤體切除，瘤壁縫合1例；單純孤立2例。結(jié)果死亡2例（13%）。其余13例經(jīng)半年的
2、隨訪，好12例（80%），差1例（7%）。結(jié)論巨大動(dòng)脈瘤手術(shù)設(shè)計(jì)應(yīng)個(gè)體化，術(shù)者應(yīng)是具備血管重建能力的有經(jīng)驗(yàn)的顯微神經(jīng)外科醫(yī)師。關(guān)鍵詞：巨大動(dòng)脈瘤；顯微手術(shù)；療效中圖分類號(hào)：R651.1文獻(xiàn)標(biāo)志碼：A文章編號(hào)：1673-4254（2012）08-1214-04doi:10.3969/j.issn.1673-4254.2012.08.33http://www.cnki.net/kcms/detail/44.1627.R.20120716.1023.009.htmlMicrosurgicalmanagementofintracranialgiantaneurysmsHUANG
3、Lijin1,FENGWenfeng2,QISongtao21DepartmentofNeurosurgeryandInterventionalRadiology,ThirdAffiliatedHospitalofSouthernMedicalUniversity,Guangzhou510630,China;2DepartmentofNeurosurgery,NanfangHospital,SouthernMedicalUniversity,Guangzhou510515,ChinaAbstract:ObjectiveTostudythesurgicaltiming,s
4、trategyandoutcomeofintracranialgiantaneurysms.MethodsTheclinicalandsurgicaldataof15casesofintracranialgiantaneurysmstreatedbetweenJanuary,2001andJanuary,2010wereanalyzed.Aneurysmclippingwasperformedin8cases,aneurysmtrappingwithextracranial-intracranial（EC-IC）bypassin1case,parentarteryocc
5、lusionwithEC-ICbypassusinggreatsaphenousveingraftin3cases,aneurysmresectionwithaneurysmwallsuturein1case,andexclusiveaneurysmtrappingin2cases.ResultsDeathsoccurredin2(13%)ofthecases.Goodsurgicaloutcomeswereachievedin12cases(80%),andpooroutcomewasfoundin1case(7%)afterthesurgery.Conclusion
6、Individualizedsurgicalplanningissuggestedformicrosurgicalmanagementofintracranialgiantaneurysms,andtheoperationshouldbeperformedbysurgeonshavingsufficientmicrosurgicalexperienceandcapableofvesselreconstruction.Keywords:intracranialgiantaneurysms;microsurgery;outcome通常將最大外徑超過2.5cm的顱內(nèi)動(dòng)脈瘤稱為
7、巨網(wǎng)膜下腔出血4例，按Hunt和Hess分級(jí)Ⅱ級(jí)1例，Ⅲ級(jí)2［1］大動(dòng)脈瘤，其發(fā)生率約占所有顱內(nèi)動(dòng)脈瘤的5%。由于例，Ⅳ級(jí)1例；腦缺血1例；神經(jīng)系統(tǒng)壓迫癥狀12例；梗巨大動(dòng)脈瘤顯著的占位效應(yīng)，使手術(shù)空間狹小，分離和阻性腦積水2例。根據(jù)部位分類：頸內(nèi)動(dòng)脈海綿竇段2顯露困難，加上動(dòng)脈瘤頸寬，瘤體易破裂出血，以及鄰近例，頸內(nèi)動(dòng)脈床突旁段3例，頸內(nèi)動(dòng)脈分叉部2例，大腦甚至是瘤體上重要穿支血管的存在，使手術(shù)治療十分困中動(dòng)脈3例（其中2例為蛇行動(dòng)脈瘤），前交通動(dòng)脈3例，難，死亡率、致殘率高，是動(dòng)脈瘤治療的難點(diǎn)。現(xiàn)將南方椎基底動(dòng)脈2例。醫(yī)院神經(jīng)外科自2
