论文部分内容阅读
目的 探讨利用大隐静脉进行颅内外搭桥,治疗海绵窦内动脉瘤的疗效,并对手术指征及手术方法进行讨论。 方法 利用大隐静脉进行颅内外搭桥手术治疗海绵窦内动脉瘤13例。手术中首先准备大隐静脉20-30 cm,并用等渗盐水加肝素充盈。根据手术前血管造影显示的侧支循环及手术中试验性夹闭颈内动脉时的脑电图监测情况,选用颈部颈内动脉或颈外动脉,利用大隐静脉与大脑中动脉搭桥。手术后随访3-63个月,平均23个月。结果 除1例患者因术后基底核血肿造成一侧肢体轻度偏瘫外,其余12例患者均恢复良好,眼球后疼痛及三叉神经痛均消失,眼球运动功能完全恢复,也无新的脑出血或脑缺血发生。结论 在严格选择病例的前提下,利用大隐静脉行颅内外高流量搭桥,仍然为治疗海绵窦内动脉瘤的有效方法。
Objective To explore the treatment of cavernous sinus aneurysm by intracranial and external bypass with great saphenous vein and to discuss the surgical indications and surgical methods. Methods Thirteen patients with cavernous sinus aneurysm were treated by intracranial and external bypass surgery with great saphenous vein. The surgery first prepared saphenous vein 20-30 cm, and with isotonic saline plus heparin filling. According to the preoperative angiography showed collateral circulation and surgery during the experimental clipping of the internal carotid artery EEG monitoring situation, use the internal carotid artery or external carotid artery, the use of saphenous vein and middle cerebral artery bypass. The patients were followed up for 3-63 months after operation, with an average of 23 months. Results All but one patient suffered from mild hemiplegia on one side due to post-operative basal nucleus hematoma. All the other 12 patients recovered well, and the retrobulbar pain and trigeminal neuralgia disappeared, and the motor function of the eye recovered completely. There was also no new cerebral hemorrhage Or cerebral ischemia. Conclusion In the strict selection of cases under the premise of the use of saphenous vein intracranial high flow bypass surgery is still an effective method for the treatment of cavernous sinus aneurysm.