眶上外侧入路治疗前循环动脉瘤临床分析

Clinical analysis of hyperacute anterior anterior circulation aneurysm via lateral supraorbital approach

目的总结86例眶上外侧入路夹闭前循环动脉瘤的疗效,并与传统翼点入路手术进行比较,评价眶上外侧入路治疗前循环动脉瘤的临床价值。方法回顾性分析2013-04—2016-10新乡市中心医院神经外科收治的86例前循环动脉瘤采用眶上外侧入路手术病例,与采用传统翼点入路手术病例进行对比,分析两者手术时间、出血量、术中显露情况,以及术后近期恢复情况。结果眶上外侧入路手术时间较对照组缩短30~55 min,差异有统计学意义(P<0.05),出血量较对照组减少200~400mL,差异有统计学意义(P<0.05),术中显露与对照组无显著性差异(P>0.05),术后近期恢复情况无显著性差异(P>0.05)。结论眶上外侧入路治疗前循环动脉瘤手术操作简单,手术时间短,出血量少,创伤小,值得临床推广。

Objective To summarize the curative effect of microsurgical treatment with lateral supraorbital approach for clipping intracranial anterior circulation aneurysm in 86 cases, and to compare with the traditional surgery with pterional approach, so as to evaluate the clinical value of lateral supraorbital approach in treatment of anterior circulation aneurysms. Methods Medical records of 86 anterior circulation aneurysm cases underwent lateral supraorbital approach, who were admitted in Neurosurgery in Xinxiang Central Hospital between April 2013 and October 2016,were retrospectively analyzed,which were also compared with those underwent traditional pterional approach（the control group）. Differences in the operative duration, bleeding volume, intraoperative exposure and postoperative recovery between the two groups were analyzed. Results Patients with lateral supraorbital approach had a shorter operative duration than those in the control group by 30-55 minutes, showing a statistically significant difference （P〈0.05） ;Bleeding volume was less than that in the control group by 200-400 mL, showing a statistically significant difference（P〈0. 05）. Moreover, there was no significant difference in both intraoperative exposure and postoperative recovery between the two groups. Conclusion The lateral supraorbital approach for the treatment of anterior circulation aneurysms has a simple operation, shorter operative duration, less bleeding and trauma,which is worthy of the clinical application.