经额底-纵裂入路夹闭前交通动脉瘤16例

16 cases of traffic aneurysm before clipping through the frontal-longitudinal approach

目的观察经额底-纵裂入路手术夹闭大脑前交通动脉瘤的临床效果,探讨此种手术方式对前交通动脉瘤的治疗价值。方法随机选取2017年1月至2018年1月本院收治的16例前交通动脉瘤患者为研究对象,在辅助检查、常规诊断以及病史调查的基础上,择期进行经额底-纵裂入路手术处理。手术处理期间,对患者的手术治疗情况进行综合性评价;手术治疗结束后,对患者的预后情况进行统计并分析。结果在手术治疗期间,共有13例患者术中分离纵裂无阻,顺利夹闭,余下3例患者出现动脉瘤破裂。在术后随访期间,共有14例患者的病情得到明显改善,且未出现后遗症。经格拉斯哥预后评分测定,患者的预后评分与术前相比显著改善,差异具有统计学意义(Х^2=10.2857,P<0.05)。结论经额底-纵裂入路手术夹闭前交通动脉瘤具有较好的临床效果,是一种有效的手术方式,可考虑临床借鉴与推广。

Objective To observe the clinical effect of anterior cerebral aortic aneurysm by transfemoral-longitudinal approach and to explore the therapeutic value of this surgical approach for anterior communicating aneurysms.Methods 16 patients with anterior communicating aneurysms admitted to our hospital from January 2017 to January 2018 were randomly selected as study subjects.On the basis of auxiliary examination,routine diagnosis and medical history investigation,the forefront-situ fissure was selected.During the surgical treatment,the patient's surgical treatment was comprehensively evaluated;after the surgical treatment,the patient's prognosis was statistically analyzed.Results During the surgical treatment,a total of 13 patients in this group had unobstructed longitudinal fissures and were successfully clipped.The remaining 3 patients had aneurysm rupture.During the postoperative follow-up period,a total of 14 patients had a significant improvement in the condition and no sequelae occurred.After the Glasgow prognosis score,the patient's prognostic score was significantly improved compared with preoperative,and the difference was statistically significant(Х^2=10.2857,P<0.05).Conclusion The anterior and posterior fissure approach has a good clinical effect in the anterior communicating aneurysm.It is a more effective surgical method and can be considered for clinical reference and promotion.