眶上外侧入路治疗前循环小型及微小型动脉瘤的临床效果  

Clinical effect of lateral supraorbital approach for patients with anterior circulation small and micro aneurysms

作　　者：宗钢 马春春[1] 沈杰[1] 汪宇阳 赵兵[1] Zong Gang;Ma Chunchun;Shen Jie;Wang Wuyang;Zhao Bing(Department of Neurosurgery,the Second Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院神经外科,合肥230601

出　　处：《心脑血管病防治》2021年第6期532-534,542,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的探讨眶上外侧入路治疗前循环小型及微小型动脉瘤的安全性和疗效。方法回顾性分析2017年1月至2020年1月在安徽医科大学第二附属医院采用眶上外侧入路夹闭术的44例患者,共计47个前循环小型及微小型动脉瘤的临床资料。结果患者平均年龄(54.89±12.15)岁,最常见的是前交通动脉瘤(44.68%),其次是大脑中动脉瘤(29.78%)。手术持续时间(126.91±26.53)min,开颅时间(30.26±5.45)min,瘤颈夹闭完全闭塞率100%,术中动脉瘤破裂3个(6.38%),与手术相关的脑梗死1例(2.27%),无1例发生术后再出血,无死亡。出院前均复查CTA,无1例瘤颈残留。术后随访6~24个月,1例后交通段小型动脉瘤复发,43例(97.72%)患者预后良好(mRS评分<2分)。结论眶上外侧入路治疗前循环小型及微小型动脉瘤安全有效,临床预后良好。Objective To assess the security and effectiveness of lateral supraorbital approach for patients with anterior circulation small and micro aneurysms. Methods The clinical and follow-up data of 44 patients with 47 anterior circulation small and micro aneurysms were retrospectively reviewed,who were underwent clipping by lateral supraorbital approach in Second Hospital of Anhui Medical University from January 2017 to January 2020. Results The mean age of patients was(54.89±12.15)years. The most common type was anterior communicating aneurysm(44.68%), followed by middle cerebral aneurysm(29.78%). The mean operation duration was(126.91±26.53) min, and craniotomy time was(30.26±5.45) min. The total occlusive rate of aneurysm clip was 100%. Intraoperative aneurysm rupture occurred in 3 cases(6.38%), operation related cerebral infarction occurred in 1 case(2.27%).There was no postoperative rebleeding occurred and the mortality rate was 0%. There was no residual neck tumor found in all patients one week after operation. All patients were followed up for 6-24 months.One patient with small posterior communicating aneurysm had recurrence, and 43 patients(97.72%) had a good prognosis(mRS score < 2 points). Conclusion Supraorbital lateral approach in the treatment of small and micro aneurysms of anterior circulation is safe and effective, and has a good clinical prognosis.

关 键 词：眶上外侧入路 小型动脉瘤 微小型动脉瘤 

分 类 号：R651.12[医药卫生—外科学]