伴有动眼神经麻痹的后交通动脉瘤的手术治疗

【】　目的　探讨伴有动眼神经麻痹的后交通动脉瘤的显微手术治疗效果。　方法　回顾性分析2008年1月―2010年12月采用显微外科手术治疗的伴随动眼神经麻痹的后交通动脉瘤患者52例的临床资料，观察动眼神经麻痹的恢复情况，总结临床经验。术后随访时间3～36个月，平均16个月。　结果　发病至手术时间14d者18例，6例（32.3%）完全恢复，12例（67.7%）不完全恢复。不完全性麻痹15例，12例（80.0%）完全恢复，3例（20.0%）得到改善；而术前完全动眼神经麻痹的37例中，仅11例（29.7%）彻底恢复、26例（70.3%）部分恢复。　结论　早期明确诊断及尽早手术治疗，对于伴随有动眼神经麻痹的后交通动脉瘤患者的神经功能恢复极为重要。【Abstract】　Objective　Toexplorethecurativeeffectofmicrosurgicaltreatmentforposteriorcommunicatingarteryaneurysmsassociatedwithoculomotorpalsy.　Methods　Theclinicaldataof52patientswithposteriorcommunicatingarteryaneurysmsassociatedwithoculomotorpalsytreatedmicrosurgicallyfromJanuary2008toDecember2010wereretrospectivelyanalyzed.Recoveryofoculomotorpalsywasobserved,andclinicalexperiencesweresummarized.　Results　Thefollow-uptimerangedfrom3to36monthswithameanperiodof16months.Amongthe34patientsoperatedonwithin14daysaftertheonsetofoculomotorpalsy,22(64.7%)showedcompleterecovery,and12(35.3%)partialrecovery.Inthe18patientsoperatedonmorethan14daysaftertheonsetofthedisease,6(32.3%)showedcompleterecovery,and12(67.7%)partialrecovery.Incompletepalsyoccurredin15patientsamongwhom12(80%)hadcompleterecoveryand3(20%)alleviation.Amongtheother38patientswithcompleteoculomotorpalsy,only11(29.7%)gotcompleterecovery,andtheremaining26(70.3%)partialrecovery.　Conclusion　Earlyandpositivediagnosisandtreatmentofpatientswithposteriorcommunicatingarteryaneurysmsassociatedwithoculomotorpalsyisofgreatimportancetothenervefunctionrecovery.