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经眶上外侧入路夹闭颅内前循环动脉瘤的临床应用

Surgical treatment of anterior circulation aneurysms via lateral supraorbital approach

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【作者】 秦冰应广宇胡华陈高张建民王林

【Author】 QIN Bin;YING Guang-yu;HU Hua;CHEN Gao;ZHANG Jian-min;WANG Lin;Department of Neurosurgery,the Second Affiliated Hospital,Zhejiang University School of Medicine;

【机构】 浙江大学医学院附属第二医院神经外科

【摘要】 目的:总结和评价经眶上外侧入路夹闭动脉瘤治疗颅内前循环动脉瘤患者的临床疗效,并与传统的翼点入路手术进行比较。方法:回顾性分析2012年10月—2014年9月收治浙江大学医学院附属第二医院神经外科采用眶上外侧入路手术的99例前循环动脉瘤患者的临床资料,并与2010年1月—2011年12月在该科住院并采用翼点入路手术的75例前循环动脉瘤患者进行比较,分析两组患者手术时间、术中动脉瘤破裂率、术后近期恢复情况、术后动脉瘤残留率等情况的差异。结果:眶上外侧入路组手术时间较翼点入路组缩短37~61 min,差异有统计学意义(P<0.05);两组术中动脉瘤破裂率、术后动脉瘤残留率等差异均无统计学意义(均P>0.05)。两组术后3个月格拉斯哥预后评分差异无统计学意义(P>0.05)。结论:眶上外侧入路治疗前循环动脉瘤具有损伤小、速度快的优点,可以作为翼点入路的良好替代方案。

【Abstract】 Objective:To evaluate the efficacy of the surgery with lateral supraorbital approach for clipping anterior circulation aneurysms.Methods:The clinical data of 99 patients with anterior circulation aneurysms who underwent a clipping via lateral supraorbital approach from October 2012 to September 2014 and 75 patients,who underwent a clipping via pterional approach from January 2010 to December 2011 in the second Affiliated Hospital,Zhejiang University School of Medicine were reviewed.The operative duration,prognosis,residual rate and rupture rate during surgery were compared between two groups.Results:The patients by lateral supraorbital approach had a shorter operative duration,namely 37~61 min less than that in the patients by pterional approach.No difference were found in residual rate and rupture rate between two groups.The Glasgow Outcome Scale(GOS) at 3 months after surgery showed no significant difference between two groups.Conclusion:The lateral supraorbital approach can be used safely and effectively with shorter operative duration and less tissue damage for treatment of patients with anterior circulation aneurysms.

【基金】 国家自然科学基金(81171096)
  • 【文献出处】 浙江大学学报(医学版) ,Journal of Zhejiang University(Medical Sciences) , 编辑部邮箱 ,2015年04期
  • 【分类号】R651.12
  • 【下载频次】53
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