经小脑延髓裂夹闭小脑后下动脉远端动脉瘤

摘要

Objective The advantages of clipping the distal posterior inferior cerebellar artery aneurysms via cerebellomedullary fissure approach and the microsurgical skills are discussed.Methods A total of 23 cases of the distal posterior inferior cerebellar artery aneurysms were clipped through cerebellomedullary fissure under the microscope.Results Among 23 cases with 33 aneurysms, 31 were totally clipped and 2 were removed, with a clipping rate of 94.9%.No operative mortality occurred.Conclusion Clipping through cerebellomedullary fissure approach can remove the hemotoma of the fourth ventricle hematoma, reduce the intracranial pressure, protect cerebellum from damage, reduce the extract of the vessels and nervous tissues to a minimum extent and the rupture of aneurysms, so the safety of surgery is improved.%目的：探讨经小脑延髓裂入路手术夹闭小脑后下动脉远端动脉瘤的优点及显微手术技巧。方法23例手术夹闭小脑后下动脉远端动脉瘤均经后颅窝正中开颅，经小脑延髓裂入路，显微镜下夹闭小脑后下动脉远端动脉瘤。结果23例患者，共33枚动脉瘤，完全夹闭31枚，2枚切除，夹闭率94．9％。无一例手术死亡。结论经小脑延髓裂入路夹闭小脑后下动脉远端动脉瘤，不需切开小脑下蚓部，可有效的清除第四脑室血肿，降低脑压。使血管神经显示更加清楚，不损伤任何小脑组织，能最大限度地减少牵拉血管及神经组织，减少动脉瘤的术中破裂，使手术更安全。术后患者不良反应小。