眶上外侧入路显微手术治疗前循环破裂动脉瘤52例

Microsurgery via supraorbital lateral approach for ruptured anterior circulation aneurysms(report of 52 cases)

目的探讨眶上外侧入路夹闭术治疗破裂前循环破裂动脉瘤的临床疗效。方法 2014年6月~2016年3月采用采用眶上外侧入路夹闭前循环破裂动脉瘤52例(观察组),同期采用翼点入路夹闭前循环动脉瘤46例(对照组)。结果观察组手术切口长度、手术时间、术中出血量及住院时间均明显低于对照组(P<0.05);而且,观察组术后并发症发生率(3.85%)明显低于对照组(19.57%;P<0.05)。两组术后GOS评分和术后复发率均无统计学差异(P>0.05)。结论与翼点入路相比,眶上外侧入路手术夹闭前循环破裂动脉瘤,手术时间短,创伤小,出血少。

Objective To explore the clinical effect of microsurgery via supraorbital lateral approach on the ruptured anterior circulation aneurysms. Methods The clinical data of 98 patients with ruptured anterior circulation aneurysms, of whom 52 patients were treated by the microsurgery via pterional approach （observed group） and 46 patients were treated by the microsurgery via supraorbital lateral approach （control group） from June, 2014 to March, 2016, were analyzed retrospectively. Results The length of incision, operation time and length of average stay were significantly shorter in the observed group than those in the control group （P〈0.05）. The volume of intraoperative blood loss was significantly fewer in the observed group than that in the control group （P〈0.05）. The complication rate （3.85%） was significantly lower in the observed group than that （19.57%） in the control group （P〈0.05）. There was no significant difference in the prognoses between both the groups （P〉0.05）. Conclusions The microsurgery via superaorbital lateral approach has the merits including short operation time, less trauma, less bleeding and so on, and is similar to the microsurgery via pterional approach in the curative effects on the ruptured anterior circulation aneurysms.