眶上外侧入路显微手术治疗前循环动脉瘤的效果评价

Effect of anterior circulatory aneurysm clipping via lateral supraorbital approach

目的 探讨眶上外侧入路显微手术治疗前循环动脉瘤的效果。方法 回顾性分析2016年1月—2020年12月南京鼓楼医院集团宿迁医院神经外科收治的59例前循环动脉瘤患者,分为眶上外侧入路组(即观察组)和经典翼点入路组(即对照组),比较两组开颅、关颅平均时间与术中出血量,术后并发症发生率,GOS评分。结果 观察组开颅、关颅平均时间,术中出血量显著少于对照组,差异具有统计学意义(P <0.05);术后并发症发生率显著少于对照组,差异具有统计学意义(P <0.05);术后6个月随访,GOS评分显示预后良好患者例数多于对照组,预后不良患者例数少于对照组,差异无统计学意义(P> 0.05)。结论 眶上外侧入路显微手术治疗前循环动脉瘤可有助于减少手术损伤,可有助于提高患者的远期预后。

Objective To explore the effect of anterior circulatory aneurysm clipping via lateral supraorbital approach.Methods 59 patients with anterior circulatory aneurysm admitted in the Department of Neurosurgery,Suqian Hospital of Nanjing Drum Tower Hospital Group from January 2016 to December 2020 were analyzed retrospectively.They were divided into the supraorbital lateral approach group(trial group)and the classical pterional approach group(control group).The average time of craniotomy and restorement,intraoperative blood loss,postoperative complication rate,GOS score were investigated between two groups.Results The average time of craniotomy,restorement of the trial group was less than the control group,the difference was statistically significant(P<0.05).The intraoperative blood loss of the trial group was less than the control group,the difference was statistically significant(P<0.05).The postoperative complication rate of the trial group was below than the control group,the difference was statistically significant(P<0.05).After 6 months of follow-up,the GOS scores of patients with good prognosis were more than the control group,the GOS scores of patients with poor prognosis were less than the control group,but the difference was not statistically significant(P>0.05).Conclusion Microsurgery of lateral supreorbital approach for anterior circulatory aneurysms maybe reduce the surgical injury and improve the long-term prognosis.