术中动脉瘤破裂的危险因素分析与经眶上外侧入路中的处理特点  

Risk factor analysis of intraoperative rupture of anterior circulation aneurysms and the treatment features of Via lateral supraorbital approach

作　　者：蒋震伟[1] 张翔[1] 许文辉[1] 宋金海 吴达[1] 

机构地区：[1]江苏大学附属宜兴市人民医院神经外科,江苏214200

出　　处：《脑与神经疾病杂志》2017年第12期761-764,共4页Journal of Brain and Nervous Diseases

摘　　要：目的探讨颅内前循环动脉瘤发生术中破裂的危险因素和应用眶上外侧入路手术中紧急处理的手术经验。方法分析应用眶上外侧入路夹闭颅内前循环动脉瘤70例(74个动脉瘤)的临床资料,对可能的预见因素进行单因素统计学分析和多因素分析、术后以格拉斯哥结果评分(GCS)评价手术效果。结果 14例发生术中再破裂(IOR),发生率为20.0%,经相应处理后都夹闭成功。统计分析结果显示:动脉瘤的位置、高改良CT Fisher分级、低年限手术者年是发生术中破裂的危险因素。结论根据眶上外侧入路手术特点,合理预见、正确处置动脉瘤术中破裂是提高手术成功率,降低死残率的关键。Objective To discuss the risk factors of intraoperative rupture （ IOR ） of anterior circulation aneurysms and treatment features via lateral supraorbital （ ISO ） approach. Methods A total of seventy patients （ seventy-four aneurysms ） with ruptured aneurysms of anterior circulation who treated with microsurgery via LSO approach were retrospectively analyzed. The statistic analysis was performed for the risk factors of IOR. The neurological functions were scored according to Glasgow Come Scale （ GCS ）. Results The number of IOR was 20, the rate of IOR was 20.0%. All the cases after appropriate treatment clip success. Statistical analysis results showed the location of the aneurysm, Modified CT fisher classification, operation life of 〈15 years were independent risk factors of intraoperative rupture occurred. Conclusion According to characteristics of LSO surgery, rational expectation, correct treatment of IOR of is to improve the success rate of surgery, the key to reduce the death rate of residual.

关 键 词：颅内动脉瘤 眶上外侧入路 术中破裂 

分 类 号：R739.4[医药卫生—肿瘤]