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目的总结采用显微神经外科手术治疗的颅内前循环动脉瘤的经验,以期进一步提高对该病的临床手术及并发症的治疗效果。方法本组16例患者中15例行单侧翼点入路,1例纵裂入路(胼周动脉的动脉瘤),手术夹闭动脉瘤16枚。结果术后因脑积水行 V-P 分流2例。3例出现精神症状,1周后消失。1例偏瘫,经康复治疗后3个月后遗留轻度偏瘫,生活可自理。本组无手术死亡。结论翼点入路是处理前循环颅内动脉瘤的很好入路,充分的术前准备,耐心细致地解剖脑池显露载瘤动脉和动脉瘤,控制性降压,适当临时阻断载瘤动脉及术后有效防治脑血管痉挛可提高手术的治疗效果。
Objective To summarize the experience of using anterior cerebral artery aneurysm treated by microsurgical neurosurgery in order to further improve the therapeutic effect on the clinical operation and complications of the disease. Methods Fifteen of 16 patients in this group underwent unilateral wing point approach, 1 had longitudinal incision (aneurysm of the corpus-carotid artery), and 16 aneurysms were occluded by surgery. Results Postoperative V-P shunt due to hydrocephalus in 2 cases. 3 cases of mental symptoms, disappeared after 1 week. 1 case of hemiplegia, 3 months after rehabilitation treatment left mild hemiplegia, life can take care of themselves. This group without surgery died. Conclusion The pterional approach is a good way to deal with anterior circulation intracranial aneurysms. The preoperative preparation is full, patiently and meticulously anatomize the cerebral cortex and reveal the parent artery and aneurysm, control the blood pressure, Artery and postoperative effective prevention and treatment of cerebral vasospasm can improve the therapeutic effect of surgery.