两种入路行前交通动脉瘤夹闭手术的分析  

Contrasting analysis on two operative approaches of anterior communicating artery aneurysms clipping surgeries

作　　者：王帅[1] 梁朝辉[1] 胡福广[1] 王立群[1] 

机构地区：[1]河北医科大学第二医院神经外科,石家庄050000

出　　处：《脑与神经疾病杂志》2017年第2期97-101,共5页Journal of Brain and Nervous Diseases

摘　　要：目的探讨翼点入路及额下纵裂入路对于夹闭前交通动脉瘤(ACA)的优缺点及适应证。方法分析手术治疗的253例ACA轻症患者的临床资料。其中153例采用翼点入路,72例采用额底纵裂入路。根据格拉斯哥预后评分对两组治疗结果进行分级评定并比较。结果经翼点入路组夹闭ACA 153个,术后随访13.2±2.4个月,根据格拉斯哥预后评分(GOS)结果 :死亡2例,差5例,良好146例。经额底纵裂手术入路组夹闭ACA72个,术后治疗结果 :死亡2例,差4例,良好66例。两组疗效比较差异无统计学意义(P>0.05)。结论两种入路行ACA的手术治疗,其疗效差异无统计学意义,但应根据动脉瘤顶朝向选择入路,可减少手术副损伤,降低手术并发症发生率,改善患者预后。Objective To analyze the merits, defects and indications of pterion approach and antediastematia approach in anterior communicating aneurysms （ ACA ） clipping surgeries.Method 253 cases of ACA clipping surgeries were analyzed retrospectively, of which pterion approach was adopted in 153 cases and antediastematia approach in 72 cases. Results 153 ACA were clipped successfully in pterion approach group. According to Glasgow outcome scale, the curative effects were poor in 5 cases, good in 145 cases and 2 patients died after 1 to 24 months following up. 72 ACA were clipped successfully in ante-diastematia approach group. According to Glasgow outcome scale, the curative effects were poor in 4 cases, good in 66 cases and 2 patients died after 1 to 24 months following up. The curative effects had no significant difference between two groups （ P〉0.05 ） . Conclusion The two operative approach groups had no significant difference in ACA clipping surgeries but had different indications. The correct choice of suitable operative approach according to the characteristics of each case was very critical to the curative effects.

关 键 词：前交通动脉瘤 手术入路 疗效 

分 类 号：R651.12[医药卫生—外科学]