[1]孙连杰　冯冠军　吴红星等.改良Paine点脑室穿刺术在颅内前循环破裂动脉瘤急性期夹闭术中的应用[J].中国临床神经外科杂志,2021,26(12):918-920.[doi:10.13798/j.issn.1009-153X.2021.12.007]
　SUN Lian-jie,FENG Guan-jun,WU Hong-xing,et al.Application of modified Paine point puncture of lateral ventricle during acute microsurgical clipping for patients with ruptured anterior circulation aneurysm[J].,2021,26(12):918-920.[doi:10.13798/j.issn.1009-153X.2021.12.007]
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改良Paine点脑室穿刺术在颅内前循环破裂动脉瘤急性期夹闭术中的应用()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
26
期数:
2021年12期
页码:
918-920
栏目:
论著
出版日期:
2021-12-25

文章信息/Info

Title:
Application of modified Paine point puncture of lateral ventricle during acute microsurgical clipping for patients with ruptured anterior circulation aneurysm
文章编号:
1009-153X（2021）12-0918-03
作者:
孙连杰　冯冠军　吴红星等
830001 乌鲁木齐，新疆维吾尔自治区人民医院神经外科（孙连杰、冯冠军、吴红星、杨小朋、帕尔哈提）
Author(s):
SUN Lian-jie;  FENG Guan-jun;  WU Hong-xing;  YANG Xiao-peng;  Parhat.
Department of Neurosurgery, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China
关键词:
颅内破裂动脉瘤; 夹闭术; 急性期; 改良Paine点; 脑室穿刺术; 疗效
Keywords:
Ruptured intracranial aneurysm;  Anterior circulation aneurysm;  Modified Paine point puncture;  Acute stage
分类号:
R 743.9; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2021.12.007
文献标志码:
A
摘要:
目的 探讨改良Paine点脑室穿刺术在颅内前循环破裂动脉瘤急性期夹闭术中的应用效果。方法 回顾性分析2019年1月至2020年8月夹闭术治疗的28例颅内前循环破裂动脉瘤的临床资料；术中均采用改良Paine点脑室穿刺术。结果 28例发病至手术时间2~70 h，平均38.5 h；穿刺成功27例，失败1例（脑室受压后狭小）。28例均无因穿刺诱发的颅内出血、颅内感染及脑脊液漏，术后发生言语障碍1例、脑梗死2例、肺部感染3例、癫痫发作1例、肢体活动障碍2例、下肢深静脉血栓形成1例。出院时GOS评分4~5分26例，3分2例。4例出院前因病情较重而无法完成CTA检查；其余24例CTA检查显示，23例动脉瘤瘤颈夹闭完全，1例显示夹闭不全。术后随访3个月~1年，22例CTA或DSA复查显示瘤颈夹闭完全、动脉瘤未显影。结论 颅内前循环破裂动脉瘤急性期，采用夹闭术治疗，术中改良Paine点穿刺术可有效、迅速释放脑脊液，降低颅内压，有助于动脉瘤的显露，提高夹闭术效果，减少并发症。
Abstract:
Objective To investigate the safety and effectiveness of modified Paine point puncture of lateral ventricle (mP-LV) in the acute clipping for the patients with ruptured intracranial anterior circulation aneurysm (IACA). Methods The clinical data of 28 patients with ruptured IACA who underwnt acute microsurgical clipping from January 2019 to August 2020 were retrospectively analyzed. The mP-LV was performed on all the patients during the clipping. Results The time from onset to operation ranged from 2 hours to 70 hours, with an average of 38.5 hours. The puncture was successful in 27 patients and failed in 1. There was no complications induced by the puncture. Postoperative speech disorder occurred in 1 patient, cerebral infarction in 2, lung infection in 3, epilepsy in 1, limb dysfunction in 2, and deep venous thrombosis of lower limbs in 1. On the discharge, 26 patients had a GOS score of 4 to 5 points, and 2 of 3 points. Four patients were unable to complete the CTA examination due to severe illness before discharge, and the CTA of the other 24 patients showed complete clipping of aneurysm neck in 23 patients and incomplete in 1. Postoperative follow-up (range, 3 months~1 year) of 22 patients showed that the aneurysm necks were completely clipped and the aneurysms were disappeared on the CTA or DSA imaging. Conclusions In the acute stage of ruptured IACA, mP-LV can effectively and rapidly release the cerebrospinal fluid to reduce the intracranial pressure, help to locate the aneurysm and improve the effectiveness of clipping.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目：新疆维吾尔自治区自然科学基金（2019D01C107）
通讯作者：帕尔哈提，E-mail：Parhat469@sohu.com
更新日期/Last Update: 1900-01-01