经翼点入路与经眶上外侧入路颅内前循环动脉瘤夹闭术的疗效比较

Comparison of the efficacy between pterional approach and transsupraorbital lateral approach for anterior intracranial circulation aneurysm clipping

目的研究经翼点入路与经眶上外侧入路动脉瘤夹闭术治疗颅内前循环动脉瘤的疗效对比。方法选取廊坊爱德堡医院神经外科自2016年2月至2018年5月收治的颅内前循环动脉瘤患者50例,其中经眶上外侧入路手术为研究组(25例),经翼点入路手术为对照组(25例),比较2组患者临床指标、手术前后血清脑损伤因子NSE与S100β水平的变化、不良反应发生率及GOS评分。结果与对照组比较,研究组切口长度小,手术与住院时间短,术中出血量少,骨窗范围小且骨窗缺损度低,患者住院时间短,差异具有统计学意义(P<0.05)。与对照组比较,研究组术后的NSE与S100β水平较低,各临床指标改善显著,GOS评分较高,不良反应发生率低,差异均具有统计学意义(P<0.05)。结论颅内前循环动脉瘤患者采用眶上外侧入路可以降低不良反应发生率,改善患者的预后效果,提高生存质量。

Objective To compare the efficacy of pterional approach and supraorbital lateral approach in the treatment of intracranial anterior circulation aneurysms. Methods Fifty patients with intracranial circulation aneurysms were selected in Aidebao Hospital from February 2016 to May 2018. Twenty-five cases were in supraorbital lateral approach group as research group, another 25 cases were in pterion approach surgery group as the control group. The clinical indicators, the changes of serum NSE and S100 levels before and after surgery, the incidence of adverse reactions and GOS scores were evaluated between the two groups. Results Compared with the control group, the study group had shorter incision length, shorter operation and hospitalization time, less intraoperative bleeding, smaller scope of bone window and lower defect of bone window, shorter hospitalization time, with statistical significance (P<0.05). Compared with the control group, the levels of NSE and S100β in the study group were lower, the clinical indicators improved significantly, the GOS score was higher, the incidence of adverse reactions was lower, the difference was statistically significant (P<0.05). Conclusion Supraorbital lateral approach can reduce the incidence of adverse reactions, improve the prognosis and quality of life in patients with intracranial anterior circulation aneurysms.