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目的回顾性分析15例单侧颈动脉结扎治疗海绵窦段动脉瘤患者病历资料,探讨颈动脉结扎的适应证、术前准备、手术方案选择、术后并发症的防治。方法 15例患者均为DSA证实的海绵窦段动脉瘤患者,其中 11例为海绵窦段巨大动脉瘤,4例为创伤性动脉瘤,术前行马它氏试验2周以上,9例为缓慢夹闭颈内动脉再行颈内动脉结扎术,2例行直接结扎颈内动脉,4例行直接结扎颈总动脉。8例术中术后行Doppler监测,全部病例术后行心电、血压等监护。结果 15例患者中,术后2例出现并发症,1例为术后第5周缓慢出现对侧肢体偏瘫,1例为术后 4h出现意识变差,肢体活动障碍,而行急诊手术再次开放颈内动脉,但术后患者仍有偏瘫。结论缓慢夹闭颈内动脉是治疗海绵窦段动脉瘤的一种可行方法。
Objective To retrospectively analyze the medical records of 15 patients with unilateral carotid artery ligation in the treatment of cavernous sinus aneurysm, and to explore the indications of carotid artery ligation, preoperative preparation, surgical options and prevention and treatment of postoperative complications. Methods Fifteen patients were all confirmed DSA-confirmed patients with cavernous sinus aneurysm. Eleven of them were giant aneurysm of cavernous sinus, and 4 were traumatic aneurysms. The prevalence of maltose aneurysm was more than 2 weeks before surgery, and 9 were slow Closure of the internal carotid artery followed by internal carotid artery ligation, 2 cases of direct ligation of the internal carotid artery, 4 cases of direct ligation of the common carotid artery. Eight patients underwent postoperative Doppler monitoring, all cases underwent ECG, blood pressure and other care. Results Complications were found in 2 of the 15 cases and 1 case of contralateral hemiparesis slowly after 5 weeks of operation. One case showed disturbance of consciousness and physical activity at 4 hours after operation, and was reopened after emergency surgery Internal carotid artery, but patients still have hemiplegia after surgery. Conclusions Slow clipping of internal carotid artery is a feasible method for treating aneurysm of cavernous sinus.