翼点入路显微手术治疗颅内前循环动脉瘤破裂急性期临床研究  

Clinical study on microsurgery via pterion approach in the treatment of patients with rupture of anterior intracranial aneurysm

作　　者：吴中亚 WU Zhongya(Department of Neurosurgery,Xinyang Central Hospital,Xinyang 464000,China)

机构地区：[1]信阳市中心医院神经外科,河南信阳464000

出　　处：《中国实用神经疾病杂志》2018年第17期1905-1910,共6页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨翼点入路显微手术治疗颅内前循环动脉瘤破裂急性期患者的疗效及对其预后的影响。方法选取2016-02—2016-12信阳市中心医院收治的34例颅内前循环动脉瘤破裂急性期患者,均采用Yasargil翼点入路显微手术。统计分析本组手术情况、预后情况、并发症发生率及手术前后神经功能缺损评分(NIHSS)与日常生活能力评分(BI)变化情况。结果本组手术用时(151.67±19.04)min、切口长度(13.41±2.70)cm、术中失血量(115.62±24.71)mL;本组预后良好率为94.12%(32/34),2例轻度残疾,无患者发生重度残疾与植物生存;术后本组NIHSS评分(6.27±1.02)分低于术前,BI评分(56.71±6.79)分高于术前,差异有统计学意义(P<0.05);本组发生脑血管痉挛1例,术后短暂性脑缺血1例,术中动脉瘤破裂出血2例,脑积水1例,并发症发生率为14.71%(5/34)。结论采用翼点入路显微手术治疗颅内前循环动脉瘤破裂急性期患者效果显著,创伤小,可减少手术用时及术中失血量,提高预后效果,改善神经功能及日常生活能力,且安全性较高,具有推广价值。Objective To investigate the efficacy of microsurgery via pterion approach in the treatment of patients with rupture of anterior intracranial aneurysm and its effect on the prognosis. Methods From February 2016 to December 2016,34 patients with acute rupture of anterior intracranial aneurysm in our hospital underwent microsurgery via Yasargil pterion approach.The operation,prognosis,incidence of complications,and changes of nerve function defect score （NIHSS） and daily living ability score （BI） before and after operation in this study were statistically analyzed. Results The operation time was （151.67±19.04） min,the incision length was （13.41±2.70） cm and the intraoperative blood loss was （115.62±24.71） mL.The good prognosis rate of this group was 94.12% （32/34）,2 cases of mild disability,no severe disability and plant survival.After operation,the NIHSS score of the group[（6.27±1.02） points]was lower than that before operation,and the BI score[（56.71±6.79） points]was higher than that before operation;the difference was statistically significant（ P 〈0.05）.There was 1 case of cerebral vasospasm,1 case of transient cerebral ischemia after operation,2 cases of aneurysm rupture and hemorrhage in the operation,and 1 case of hydrocephalus.The incidence of complications was 14.71% （5/34）. Conclusion The efficacy of microsurgery via pterion approach in the treatment of patients with rupture of anterior intracranial aneurysm is remarkable.It has slight trauma,and it can reduce the time of operation and the amount of blood loss,improve the prognosis,the nerve function and the daily life ability.Besides,the safety is high,and it has the value of promotion.

关 键 词：翼点入路 显微手术 颅内前循环动脉瘤破裂 急性期 预后 NIHSS评分 

分 类 号：R739.41[医药卫生—肿瘤]