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目的探讨海绵窦和床突周围段动脉瘤的特点、分类及手术适应证和方法。方法全部采用直视手术处理动脉瘤和暴露控制载瘤动脉近远端,磨除前床突和视神经管上壁及外侧嵴,经内侧三角进入海绵窦,夹闭动脉瘤后视神经充分减压。出院时按GOS评定治疗效果。结果18例动脉瘤全部得以夹闭,其中15例术后复查造影动脉瘤完全消失。视力视野障碍明显改善。疗效好16例,疗效差和死亡各1例。结论海绵窦动脉瘤在不适合栓塞的情况下应采取手术,而床突周围段动脉瘤则应首选手术治疗。
Objective To investigate the characteristics, classification, surgical indications and methods of cavernous sinus and perioccipital peripheral aneurysms. Methods All patients underwent direct surgical treatment of aneurysms and exposure to the proximal and distal of the parent artery. The anterior and lateral cristae of the optic disc were ablated. The medial trigones entered the cavernous sinus, and the optic nerve was decompressed fully after the aneurysm was closed. Discharged by GOS assessment of treatment. Results All 18 cases of aneurysms were closed, of which 15 cases of contrast-assisted angiography completely disappeared. Visual impairment improved significantly. Good effect in 16 cases, poor efficacy and death in 1 case. CONCLUSIONS: Cavernous sinus aneurysms should be surgically treated when they are unsuitable for embolization, while peripheral aneurysms should be the first choice for surgical treatment.