Morioka M, Marubayashi T, Masumitsu T, Hori T, Ushio Y
Department of Neurosurgery, Kumamoto University Medical School.
Neurol Med Chir (Tokyo). 1991 Mar;31(3):135-40. doi: 10.2176/nmc.31.135.
A gauze sponge wrapping method to prevent recurrent subarachnoid hemorrhage (SAH) after incomplete obliteration of intracranial aneurysm or a residual neck after clipping was developed and tested. The authors performed the gauze wrapping for aneurysms with incomplete obliteration by clipping alone, abnormal changes of the parent artery wall which had the possibility of regrowth or rerupture, and surgical difficulties. The residual neck of the aneurysm or the abnormal arterial wall was tightly and completely wrapped, including the parent artery, and cemented with plastic adhesive. Seventy-eight (22.3%) of 349 surgically treated aneurysms were treated by gauze wrapping (26 wrapping only, 52 clipping and wrapping). The incidence of complications such as infection, angiospasm, and normal pressure hydrocephalus, and the clinical outcome were not significantly different for the wrapping and non-wrapping groups. No recurrent SAH was observed in the wrapping group during 3 months to 8.5 years follow-up. These results suggest that wrapping with gauze sponge is useful in the treatment for ruptured aneurysms which cannot be totally obliterated.
我们开发并测试了一种纱布海绵包裹方法，用于预防颅内动脉瘤夹闭不完全或夹闭后残留颈部导致的复发性蛛网膜下腔出血（SAH）。作者对仅通过夹闭无法完全闭塞的动脉瘤、存在再生长或再破裂可能性的母动脉壁异常变化以及手术困难的情况进行了纱布包裹。动脉瘤的残留颈部或异常动脉壁被紧密、完全地包裹，包括母动脉，并使用塑料粘合剂固定。349例接受手术治疗的动脉瘤中有78例（22.3%）采用了纱布包裹治疗（仅包裹26例，夹闭并包裹52例）。包裹组和非包裹组在感染、血管痉挛和正常压力脑积水等并发症的发生率以及临床结果方面没有显著差异。在3个月至8.5年的随访期间，包裹组未观察到复发性SAH。这些结果表明，用纱布海绵包裹对无法完全闭塞的破裂动脉瘤治疗是有用的。
