| 宋旭,汤宏杰,张桐,等.破裂的后交通动脉镜像动脉瘤的诊断与显微外科治疗[J].安徽医药,2022,26(12):2412-2415. |
| 破裂的后交通动脉镜像动脉瘤的诊断与显微外科治疗 |
| Diagnosis and microsurgical treatment of ruptured posterior communicating artery mirror aneurysm |
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| DOI：10.3969/j.issn.1009-6469.2022.12.017 |
| 中文关键词: 颅内动脉瘤 脑血管重建术 动脉瘤，破裂 颈内动脉 显微外科手术 |
| 英文关键词: Intracranial aneurysm Cerebral revascularization Aneurysm, ruptured Carotid artery, internal Microsurgery |
| 基金项目:国家自然科学基金青年项目( 82002632) |
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| 中文摘要: |
| 目的探讨破裂的后交通动脉镜像动脉瘤的诊断与治疗方法。方法通过研究中心影像储存和传输系统确诊徐州医科大学附属医院神经外科 2015年 5月至 2021年 5月破裂后交通动脉( PCoA)镜像动脉瘤病人 24例，回顾性分析病人的临床资料和手术疗效。结果本组动脉瘤直接夹闭 24例。动脉瘤夹闭术病人中，行一期手术 21例，单侧开颅夹闭一侧动脉瘤 12例、夹闭双侧动脉瘤 8例，双侧开颅夹闭动脉瘤 1例；行二期手术 3例，其中一期显微外科手术夹闭动脉瘤 3个，二期通过显微外科手术夹闭动脉瘤 3个。行一侧动脉瘤通过显微外科手术夹闭后对侧动脉瘤未处理有 12例病人。病人术后均行头颅计算机断层血管造影(CTA)复查，通过显微外科夹闭的 24例动脉瘤病人中有 2例病人动脉瘤瘤颈残留，其余病人动脉瘤均消失，载瘤动脉通畅。通过格拉斯哥预后( GOS)评分显示恢复优良 17例，轻残 5例，重残 2例。结论 PCoA镜像动脉瘤应积极治疗，根据病人出血部位、 Hunt-Hess临床分级、动脉瘤的位置、动脉瘤大小和形态，本组均行显微外科治疗，采用早期与晚期、一期与分期相结合的方法处理动脉瘤，可达到良好的治疗效果。 |
| 英文摘要: |
| Objective To investigate the diagnosis and treatment of ruptured posterior communicating artery mirror aneurysms. Methods Twenty-four patients with ruptured posterior communicating artery (PCoA) mirror aneurysms from May 2015 to May 2021 werediagnosed in the Department of Neurosurgery, Affiliated Hospital of Xuzhou Medical University,through the imaging storage and transmis.sionsystemoftheresearchcenter,andtheclinicaldataandsurgicaloutcomesofthepatientswereretrospectivelyanalyzed.Results There were 24 cases of direct aneurysm clamping in this group. Among the patients with aneurysm clipping, 21 patients underwent stage I sur.gery, including 12 cases of unilateral craniotomy to clip one side aneurysm, 8 cases of bilateral aneurysm clamping, and 1 case of bilateralcraniotomy to clip aneurysm; 3 patients underwent stage Ⅱ surgery, including 3 aneurysms clamping by microsurgery in stage I and 3 an.eurysms clamping by microsurgery in stage Ⅱ. There were 12 patients who underwent microsurgical clamping of aneurysms on one sideand then left the aneurysm on the opposite side untreated. All patients were reexamined by computed tomographic angiography (CTA) af.ter the operation. Among the 24 patients with aneurysms clipped by microsurgery, 2 patients had residual aneurysm neck, and the otherpatients had no aneurysm and the parent artery was unobstructed. According to the Glasgow Outcome Scale (GOS), 17 patients recoveredwell, 5 patients were slightly disabled, and 2 patients were severely disabled.Conclusion PCoA mirror aneurysms should be actively treated. According to the bleeding site, Hunt-Hess clinical grade, aneurysm location, aneurysm size and shape, microsurgery should beperformed. A combination of early and late, stage I and stage Ⅱ approaches to managing aneurysms can lead to good outcomes. |
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