【摘要】 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lt;14 d患者34例，22例（64.7%）完全恢复，12例（35.3%）部分恢复。gt;14 d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 To explore the curative effect of microsurgical treatment for posterior communicating artery aneurysms associated with oculomotor palsy. Methods The clinical data of 52 patients with posterior communicating artery aneurysms associated with oculomotor palsy treated microsurgically from January 2008 to December 2010 were retrospectively analyzed. Recovery of oculomotor palsy was observed, and clinical experiences were summarized. Results The follow-up time ranged from 3 to 36 months with a mean period of 16 months. Among the 34 patients operated on within 14 days after the onset of oculomotor palsy, 22 (64.7%) showed complete recovery, and 12 (35.3%) partial recovery. In the 18 patients operated on more than 14 days after the onset of the disease, 6 (32.3%) showed complete recovery, and 12 (67.7%) partial recovery. Incomplete palsy occurred in 15 patients among whom 12 (80%) had complete recovery and 3 (20%) alleviation. Among the other 38 patients with complete oculomotor palsy, only 11 (29.7%) got complete recovery, and the remaining 26 (70.3%) partial recovery. Conclusion Early and positive diagnosis and treatment of patients with posterior communicating artery aneurysms associated with oculomotor palsy is of great importance to the nerve function recovery.
目的:探讨内镜在梗阻性脑积水治疗中的临床应用价值。方法:将我院80例梗阻性脑积水患者随机分为治疗组及对照组,对照组患者采用分流术,治疗组患者采用神经内镜下三脑室底造瘘术。结果:治疗组均造瘘成功,无中转分流术。手术时间治疗组明显短于对照组,术后并发症例数也明显少于对照组,差异有统计学意义(Plt;0.05),术后症状缓解率差异无统计学意义(Pgt;005)。两组患者均获随访,时间6～12个月,症状均有锁缓解,复查CT或MRI见脑室均有不同程度缩小.结论:ETV治疗梗阻性脑积水符合当今神经外科微创原则,疗效确切,手术时间短、脑暴露少、对组织损伤小,手术费用降低,并发症少,值得推广。
目的:研究微创侧脑室穿刺联合置管外引流术治疗脑室出血的疗效。方法:将我院48例脑室出血患者随机分为治疗组及对照组,对照组采用常规内科药物治疗,治疗组在对照组基础上采用微创侧脑室穿刺联合置管外引流术。结果:治疗组的总有效率为83.33%,显著高于对照组的50.0%,死亡率显著低于对照组,以上差异有统计学意义(Plt;0.05)。结论:微创侧脑室穿刺联合置管外引流术治疗脑室出血效果好,损伤小、操作简便易行,缩短了病程,显著降低了患者致残率及死亡率,及早手术,可提高治愈率和生存质量,值得推广。