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-  2015 

颈内动脉窝动脉瘤的显微手术治疗 Microsurgical Management of Carotid Cave Aneurysm

Keywords: 颈内动脉窝,颅内动脉瘤,前床突,蛛网膜下腔出血

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Abstract:

目的:探讨颈内动脉窝动脉瘤的显微手术技巧、并发症及影响预后的因素。方法:回顾性分析经显微手术治疗的25例颈内动脉窝动脉瘤患者的临床资料、影像学资料、手术方法及预后。结果:本组患者平均年龄50.2岁(35-72岁)。女性发病多见,女∶男=2.57∶1。主要临床表现为突发头痛,占64.0%;其次为视力、视野损害,占28.0%。Hunt-Hess分级:Ⅰ级2例,Ⅱ级5例,Ⅲ级5例,Ⅳ级4例。本组25例均采用翼点入路,硬膜外磨除前床突,剪开远侧硬膜环后行动脉瘤夹闭术。术后偏瘫2例(8.0%),动眼神经麻痹5例(20.0%),视野缺损2例(8.0%),切口感染1例(4.0%)。随访6-36个月,恢复良好18例(72.0%),轻度残疾3例(12.0%),重度残疾4例(16.0%)。统计学分析表明老年患者及Hunt-HessⅣ级者预后不良(P<0.05)。结论:显微手术是治疗颈内动脉窝动脉瘤的有效方法。良好的术中暴露是提高手术疗效的关键

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