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Jingdong book

神经血管手术技巧

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Jingdong book

神经血管手术技巧

Name: 神经血管手术技巧
Brand: Jingdong book
SKU: 3117015311
Price: 178.07 USD
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一本全新的展示显微外科手术和血管内治疗的书籍
《神经血管手术技巧》是最前沿的学术专著，着重介绍多种神经血管疾病的外科手术技巧，包括脑动脉瘤、AVM、海绵状血管瘤、脑卒中和脊髓血管异常等许多疾病，并且特别强调了最新的血流导向技术。
本书展示了最先进的技术，如应用胶栓塞动脉瘤、血流导向技术、急性脑卒中的干预以及显微神经外科和血管内神经外科的未来创新趋势。
本书由血管神经外科领域的国际知名专家撰写，并配有大量图表以阐明相关技术。

Content Description

《神经血管手术技巧》是第一部关于开放手术和血管内治疗神经血管疾病的书籍。每个章节都分为两部分，分别详述开放手术技术和血管内技术。所有章节都由这一领域神经外科、神经病学和介入神经放射学等不同知识背景的权威撰写而成。本书涉及神经血管疾病的广阔范围，从基础血管解剖到最复杂的疾病及最新、最具创新性的治疗方法

Author Description

帕斯卡·M·杰伯，美国Thomas Jefferson大学附属医院神经外科专家，他是接受过血管显微外科技术和血管内技术双重培训的少数神经外科医生之一。

黄海东，医学博士，副主任医师，脑血管病组组长，成都军区神经外科专业委员会委员；匡永勤，成都军区总医院神经外科，医学博士，副主任医师；顾建文，成都军区总医院神经外科主任医师，神经外科主任，教授，成都军区总医院副院长，博士研究生导师，成都军区神经肿瘤研究所所长。

Catalogue

第1章脑动脉解剖基础
第2章脑静脉解剖基础
第3章显微外科手术器械概述
第4章血管内材料的概述
第5章神经系统血管性疾病的影像学进展
第6章前循环动脉瘤的显微外科手术和血管内治疗
第7章后循环动脉瘤的显微外科手术和血管内治疗
第8章巨大动脉瘤的显微外科手术和血管内治疗
第9章液体栓塞剂在颅内动脉瘤治疗中的应用
第10章脑动脉瘤的生物力学
第11章血流导向：脑动脉瘤治疗的新模式
第12章脑动静脉畸形的显微外科手术和血管内治疗
第13章颅内闭塞性血管疾病
第14章颅外动脉粥样硬化
第15章急性脑卒中的介入治疗
第16章颈动脉海绵窦瘘
第17章颅内动静脉瘘：分类、显微外科手术和血管内治疗
第18章创伤性血管损伤
第19章脊髓动静脉畸形
第20章未来血管内技术的进步
第21章未来的显微外科技术展望
第22章血管内技术困难的解决与并发症的避免
第23章显微外科手术困难的解决与并发症的避免
第24章海绵状血管瘤的手术：要诀和教训
第25章神经外科术中脑血流量检测应用的过去、现在和将来
索引

Book Abstract

幕下AVM和手术入路
少数颅内AVM位于幕下（10%~18%），但与幕上AVM相比，幕下AVM出血发生率较高，因而更易出现出血症状。其他常见症状包括占位效应引起的局灶性神经功能缺损和头痛。幕下AVM患者很少出现癫痫发作症状。幕下AVM可能会累及3个结构：小脑、脑干或两者均累及。这些病变往往靠近主要的运动束和感觉束、颅神经或者其相关核团、本体感觉通路和小脑深部核团。根据定义，所有幕下的AVM均具有的一个深部静脉引流组成成分。
治疗上，幕下AVM比幕上AVM更适合使用综合治疗，包括栓塞、显微外科手术和（或）放射治疗。由于大多数这些病变伴有出血表现，外科手术初步的目标应该是减轻占位效应和伴发的脑积水。在尝试对AVM治疗前，通常应给患者几周恢复时间，以稳定病情和改善神经功能。此延迟期间内必须通过术前脑血管造影检查来充分评估AVM血管构筑情况。任何相关的动脉瘤或高流量瘘，应该在手术切除AVM之前进行治疗，特别是如果认为它们可能是出血起源点时。一旦患者恢复良好和（或）神经功能改善到最佳时，可考虑进行手术切除AVM。
与深部的病变相比，软脑膜表面的幕下AVM更适合手术切除。外科医生可判定术前是否需要进行血管内栓塞。如果某个病变从外科手术角度处理具有高风险，应该考虑保守观察或放射治疗。目前治疗幕下AVM的策略包括显微手术切除、血管内栓塞和放射治疗（表12.2），并发症发生率和死亡率波动在20%~50%之间。
处理幕下AVM的主要手术入路就是常用于处理后颅窝病变的那些入路（图12.4）。患者通常取3/4侧俯卧位或俯卧位，也可采用坐位，但坐位会增加空气栓塞的风险。并且坐位手术时，外科医生需要将手保持伸直状态，其在手术过程中并不舒服。对于累及中线的AVM，如小脑蚓部、小脑半球中线旁、延髓背侧和第四脑室，可采用枕下中线入路。根据AVM尾部的范围，必要时可以考虑切除C1椎板。大多数累及小脑半球、脑桥前外侧和延髓上部的侧方AVM，通常采用乙状窦后入路进行开颅手术。累及前外侧延髓下部和枕骨大孔的AVM，最好选择经标准枕下远外侧入路行开颅术。此入路非常适合术中进行无框架立体定向导航，特别是定位椎动脉以防止医源性损伤。权威专家（RFS）对于远外侧入路更喜欢使用旁正中直切口，这可最大限度减少软组织牵拉和术后患者的不适。
……

Introduction

对于神经外科医生而言，在神经外科发展首个百年历程中的多数时间里，血管技术仍然单调沉闷且富有挑战性。它考验着这一领域开创者的技术、勇气和创造性。自Harvey Cushing在《神经外科特殊领域》（《约翰·霍普金斯医院期刊》16：77-87，1905）上发表宣言后的几十年里，神经血管干预技术是少数神经外科医生水平的体现，其中包括一些大师级的专家，如Cushing本人、Dandy、Olivecrona、Penfield及后来的Yasargil、Malis等专家。这些早期神经外科大师们的神经血管手术之所以疗效显著，主要是因为他们采取的手术方式可行性强，手术技巧精湛，而并不是因为相对非血管性病例的手术量多。直到20世纪后期的几十年，包括Drake和Sundt在内的少数大师级外科医生才成为早期的神经血管外科医生。安全处理脑血管的特有技术和显微器械、安全可靠的脑血管造影技术及后来的血管断层成像技术的应用，促进了神经血管外科技术的发展。20世纪80年代初期，在Spetzler、Heros、Samson、Mullan、Ojemann、Ausman、Hopkins、Tew等人的引领下，神经血管外科学的亚专业培训事业得到长足发展，出现了神经血管精细分科的专业学校。神经血管外科学相关的部门和项目都成为一些优秀医疗中心的核心部门，并由包括Barrow、Martin、Batjer、Ogilvy、Charbel、Morcos、Lawton等在内的知名专家领导。21世纪初期，血管内技术逐渐影响神经血管疾病治疗方案的决策和讨论。同时，涌现出一大批对神经外科医生进行血管内技术培训的学校。开放手术和神经血管内治疗策略及技术的多学科结合成为成熟神经血管外科新项目的必要组成部分，也成为对未来神经外科医生最终培训的必不可少的一部分。这一领域早期的杰出人物，如Mullan和Drake，以及后来的Hopkins和Rosenwasser，已经预测到这一趋势，并为之发展积极努力。
Jefferson 学校是一所由Robert Rosenwasser及其同事所共同领导的神经血管技术创新方面的重点学校，也是最高水平的血管内治疗技术和开放手术技术的双重培训和实践的理论发源地。他们的规模和经验为他们赢得了这一领域的领导地位。Pascal M. Jabbour是出自这所学校的后起之秀，他思维严谨、技术过硬，承担了汇集当今神经血管技术纲要这一令人钦佩的任务。随着这些技术不断发展成熟，他个人的职业经验也不断成熟，因此，他的观点确切、新颖、务实。与此前出版的本领域相关书籍不同，针对各种病理情况，这本新书包含了对血管内治疗与开放手术概念和工具的实践评价。全书25个章节均由这一领域的知名专家撰写。年轻创新者及经验丰富的专家为我们展示了在策略、决策、技术决定和执行方面的无数教学珍品。
本书的前几章通过对静脉循环、显微血管外科和血管内治疗的工具和设备以及新颖的血管成像等方面进行论述，对Rhoton的经典解剖进行了补充。本书还权衡论述了血管内治疗及开放手术在动脉瘤、血管畸形及（血管）闭塞性疾病等方面的作用。此外，本书还包括了急性卒中、神经血管损伤及脊髓血管畸形等方面的论述。倡导一种技术方法的做法在过去大多数出版物中普遍存在，但现在已被全新的多学科性“问题求解”方法所取代，这种方法真实地展示了不同技术的优点和不足。最后几章探讨了未来的趋势、海绵状血管畸形手术中所特有的特殊显微外科的珍贵案例，以及量化血管动力学在神经血管治疗中的应用。
本书既不针对也不受那些关于生物学的、发病机制、自然病史或转归相关权威综述的影响。本书如手术刀（或导管头端）般精确地集中剖析了相关技术的可能性及其实践经验。其中对技术策略与临床实践的交叉论述方式令人惊叹，此方式影响着神经血管疾病中的临床决策。本书反映了神经血管外科技术的新思维方式，无缝交叉整合了血管内治疗和显微手术领域。本书将从多层次的训练、精细分科和经验等方面增强神经外科医生的基础知识和智慧。在那些充满知识和友爱的文字中，每个人都将受益匪浅。这便是这本书的特殊之处所在。
Issam Awad
美国伊利诺伊州芝加哥
芝加哥大学医学和生物科学
血管外科主任
神经学和肿瘤中心
外科（神经外科）教授

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