经眶上锁孔入路显微外科夹闭前交通动脉瘤

Microsurgery clipping of anterior communicating artery aneurysm via-supraorbital keyhole approach

目的探讨经眶上锁孔入路显微外科夹闭前交通动脉瘤的手术技巧及临床效果。方法回顾性分析27例经眶上锁孔入路显微外科手术夹闭前交通动脉瘤患者的临床资料。分析术前影像学特征、术中动脉瘤分离夹闭过程及术后复查随访结果。应用格拉斯哥预后量表(GOS)评分评定手术的疗效。结果本组27例患者均成功行眶上锁孔入路夹闭前交通动脉瘤。术后经CTA或DSA检查证实动脉瘤夹闭满意,未见动脉瘤残留、复发。术后随访患者6个月~2年,按GOS评分标准:恢复良好者24例(88.9%),轻残2例(7.4%),重残1例(3.7%),无死亡病例。结论经眶上锁孔入路显微外科夹闭前交通动脉瘤的手术视野显露充分,动脉瘤夹闭满意,创伤小,并发症少,安全有效。

Objective To explore and evaluate the surgical technique and clinical effect of anterior communicating artery via-supraorbital keyhole approach.Methods The clinical data of 27 patients with anterior communicating artery aneurysm for microsurgery clipping via-supraorbital keyhole were analyzed retrospectively.Preoperative imaging features,intraoperative aneurysm dissection and clipping process and postoperative follow-up were analyzed.Glasgow outcome scale(GOS)was used to evaluate the therapeutic effect.Results 27 cases were successfully operated via-supraorbital keyhole and no residual or recurrence of aneurysm was confirmed by CTA or DSA.According to GOS grade,24 cases(88.89%)recovered with good outcome,2(7.41%)of mild disability and 1(3.70%)case of severe disability with the follow-up from 6 months to 2 years.Conclusion Exposure and clipping for anterior communicating artery aneurysm via-supraorbital keyhole approach is safe and effective and it has less trauma and complications.