翼点锁孔入路治疗颅内前循环动脉瘤  

Microsurgical treatment of anterior circulation aneurysm via pterion keyhole approach

作　　者：罗靖[1] 程宝春[1] 赵亮[1] 程宏伟[1] 李志范[1] 冯春国[1] 王晓健[1] 

机构地区：[1]安徽医科大学第一附属医院神经外科,合肥230022

出　　处：《安徽医学》2013年第9期1276-1278,共3页Anhui Medical Journal

基　　金：国家十二五科技支撑计划项目(项目编号:2011BAI08B06)

摘　　要：目的 探讨翼点锁孔入路治疗前循环动脉瘤的可行性、适应证和手术方法.方法 采用翼点锁孔入路显微手术夹闭26例患者共28枚颅内前循环动脉瘤,其中前交通动脉瘤11例,后交通动脉瘤9例,大脑中动脉瘤6例,患者Hunt-Hess分级0~Ⅲ级.结果 全部26例均成功夹闭,无死亡病例,所有患者均未出现严重神经功能障碍和面神经额支损伤所造成的面瘫表现.19例患者术后随访DSA或CTA检查,未见动脉瘤残留、复发.结论 翼点锁孔手术能有效降低开颅手术创伤,减少术后并发症,加快术后康复,是一种微创、安全有效的手术方法,可选择性地应用于部分前循环动脉瘤.Objective To investigate the feasibility, indications and the surgical technique of pterion keyhole approach for treating anterior circulation aneurysm. Methods Aneurysm clipping though the pterion keyhole approach was performed in 26 patients with total 28 anterior circulation aneurysms including l 1 with anterior communication artery aneurysms, 9 with posterior communication artery aneurysms and 6 with middle cerebral artery aneurysms. All patients were in stages 0 to III according to Hunt - Hess scale. Results All the aneurysms in all 26 patients were clipped successfully. No patient died or experienced severe neurological dysfunction. No facial paralysis occurred due to damage of the facial nerve. Digital subtraction angiography（DSA） or computed tomography angiography（CTA） follow-up in 19 patients showed that the clipping was well done. Conclusion Microsurgery via pterion keyhole approach can reduce surgical trauma and complications effectively and promote recovery. It can be applied selectively to some patients with anterior circulation aneurysms as a minimally inva- sire, safe and effective surgical method.

关 键 词：颅内动脉瘤 翼点入路 锁孔显微手术 

分 类 号：R651.1[医药卫生—外科学]