由于动脉瘤剪切期间的三角形心脏反射引起的过渡性心脏骤停:说明性的案例
Yuto Ando1, Takenori Kato1, Masaki Sumitomo2
1Department of Neurosurgery, Komaki City Hospital, Komaki, Aichi.
Journal of neurosurgery. Case lessons
|December 4, 2025
概括
三等内心反射 (TCR) 很少会在 supratentorial动脉瘤剪切过程中导致心脏骤停. 修改手术方法和剪贴选择可以防止这种并发症,强调了谨慎的手术技术的重要性.
科学领域:
- 神经外科 神经外科
- 神经学 神经学
- 心脏病学 心脏病学
背景情况:
- 三角神经反射 (TCR) 涉及由于三角神经刺激而导致的胸和低血压.
- 虽然在后腔手术中很常见,但在 supratentorial动脉瘤剪切过程中导致心脏骤停的TCR很少见.
研究的目的:
- 在 supratentorial动脉瘤剪切过程中报告一个罕见的TCR病例.
- 在神经外科手术期间突出TCR的预防策略.
主要方法:
- 一个案例报告,一名88岁的妇女接受了破裂的内动脉-后部通讯动脉动脉瘤的剪切.
- 采用了pterional方法,并在剪贴应用期间记录了手术内心脏骤停.
- 修改了剪贴几何和手术轨迹,以避免持续接触.
主要成果:
- 在最初的剪贴应用过程中发生了8秒心脏骤停,在撤回时得到解决.
- 成功切断动脉瘤是通过直实现的,避免持续接触,防止心脏骤停的复发.
结论:
- 上垂体动脉瘤剪切可以通过刺激三角管内置的持续结构来触发TCR.
- 改变剪贴几何形状和手术方法成功地预防了并发症.
- 仔细选择剪切片和空间解剖学的考虑对于在动脉瘤手术期间预防TCR至关重要.
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