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学科主题: 神经病学
题名:
后交通动脉动脉瘤瘤颈位置与分型
其他题名: Neck localization and classification for aneurysms of posterior communicating artery
作者: 李良; 段鸿洲; 伊志强; 张扬
关键词: 后交通动脉动脉瘤 ; 瘤颈位置 ; 分型 ; 瘤夹选择 ; Posterior communicating artery aneurysm ; Location of aneurismal neck ; Classification ; Choice of clip
刊名: 中华神经外科杂志
发表日期: 2012
DOI: 10.3760/cma.j.issn.1001-2346.2012.11.014
卷: 28, 期:11, 页:1120-1123
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 探讨后交通动脉动脉瘤的瘤颈位置和分型,以指导手术中动脉瘤夹的选择.方法 回顾2007年1月至2012年6月北京大学第一医院单一术者开颅手术夹闭的后交通动脉动脉瘤患者的临床资料,搜集其瘤颈位置、宽窄、术中动脉瘤夹类型和型号等.瘤颈位置按时钟模式的12个钟点方向分类,根据动脉瘤颈与载瘤动脉的关系对动脉瘤进行分型.术后对患者以门诊、电话、脑血管造影进行随访.结果 55例后交通动脉动脉瘤开颅夹闭病例纳入研究.瘤颈位置和宽窄按时钟模式的12个钟点方向记录:位于1个钟点的3例,跨两个钟点的42例,跨三个钟点的10例.根据动脉瘤颈与载瘤动脉的关系分为颈内动脉、后交通动脉、分叉三种类型.其中分叉型30例、颈内动脉型20例、后交通型5例.84%(46/55,30例分叉型、13例颈内动脉型、3例后交通动脉型)动脉瘤选用弯型动脉瘤夹,11% (6/55)直型,4%(2/55)成角度跨血管型,2% (1/55)枪型.术后随访1个月-5年,所有患者均无动脉瘤复发及破裂的临床表现,21例行DSA检查随访患者动脉瘤颈均夹闭完全,未见动脉瘤残留.结论 后交通动脉动脉瘤瘤颈位置和宽窄对动脉瘤夹的选择至关重要,弯型动脉瘤夹在本组后交通各型动脉瘤中使用最多,建议首选. Objective Studied on aneurismal neck localization and classification in order to facilitate selection of clips during operations for aneurysms of posterior communicating artery (PcoA).Methods Accumulating and analyzinganeurismal neck location,broadness,type of clips of all the PCoA aneurysms operated by single operator between January 2007 and June 2012 based on operative records,retrospectively.Location and broadness of the aneurismal neck was recorded in clock manner.Aneurysm classification was done base on the relation between the aneurismal neck and parent artery.All cases were followed up by means of consulting,telephone,and DSA.Results 55 cases of PCoA aneurysms were enrolled into this study.There were 3 cases,the aneurismal neck located in only one clock region,while 42cases the neck stepped over two clock region,and 10 cases occupied three clock region.Three types were classified as junctional,internal carotid artery(ICA),and true posterior communicating artery,and cases of these types were 30,20,5,respectively.Among the clips used during operations,there were 84% (46/55)bent type,11% (6/55) straight,4% (2/55) angled fenestrated,and 2% (1/55) bayonet-shaped.Postoperative follow-up show that all patients recovered well without recurrence and re-rupture.Merely twenty-one cases went for DSA examination,however,completeneck occlusion without residue were demonstrated in all cases.Conclusion The location and broadness of the aneurismal neck of the posterior communicating artery aneurysm was extensively important for clip selecting.According to our experience,bent clip may be the first choice for obliterating PCoA aneurysms.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/41570
Appears in Collections:北京大学第一临床医学院_神经外科_期刊论文

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作者单位: 北京大学第一医院神经外科,100034
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