眶上额外侧入路开颅夹闭术治疗前循环动脉瘤破裂的临床效果  

Clinical Effect of Craniotomy Clipping by Lateral Supraorbital Approach in the Treatment of Patients with Ruptured Anterior Circulation Aneurysm

作　　者：蔡沉逐 郭协力[1] 王佳音[2] 齐震 蔡明发[1] CAI Chenzhu;GUO Xieli;WANG Jiayin;QI Zhen;CAI Mingfa(Department of Neurosurgery,Jinjiang City Hospital,Jinjiang 362200,China;不详)

机构地区：[1]晋江市医院(上海市第六人民医院福建医院)神经外科,福建晋江362200 [2]福建医科大学附属第二医院神经外科,福建泉州362000

出　　处：《中国医学创新》2024年第28期52-56,共5页Medical Innovation of China

摘　　要：目的:探究眶上额外侧入路开颅夹闭术治疗前循环动脉瘤破裂的临床效果。方法:将2020年1月—2023年12月于晋江市医院进行开颅夹闭治疗的前循环动脉瘤破裂患者100例根据随机数字表法分为对照组(n=50)和观察组(n=50)。对照组进行翼点入路开颅夹闭治疗,观察组进行眶上额外侧入路开颅夹闭治疗。比较两组治疗效果、术中出血量、手术时间、住院时间、并发症发生率,以及手术前后神经功能评分[美国国立卫生研究院卒中量表(NIHSS)评分]、神经损伤指标[神经元特异性烯醇化酶(NSE)、S100钙结合蛋白B(S100B)及髓鞘碱性蛋白(MBP)]、创伤应激指标[β-内啡肽(β-EP)、白介素-6(IL-6)及强啡肽A1-13(DynA1-13)]。结果:术后3个月,观察组总有效率显著高于对照组,术中出血量显著少于对照组,手术时间及住院时间均显著短于对照组,差异均有统计学意义(P<0.05)。两组并发症发生率比较,差异均无统计学意义(P>0.05)。术前两组NIHSS评分、神经损伤指标及创伤应激指标比较,差异均无统计学意义(P>0.05),术后7 d,观察组NIHSS评分、神经损伤指标及创伤应激指标均显著低于对照组,差异均有统计学意义(P<0.05)。结论:眶上额外侧入路开颅夹闭治疗前循环动脉瘤破裂的临床效果较好,其可有效控制神经损伤及机体创伤应激,促进患者术后恢复。Objective:To investigate the clinical effect of craniotomy clipping by lateral supraorbital approach in the treatment of patients with ruptured anterior circulation aneurysm.Method:A total of 100 patients with ruptured anterior circulation aneurysm who received craniotomy clipping treatment in Jinjiang City Hospital from January 2020 to December 2023 were divided into control group(n=50)and observation group(n=50)according to random number table method.The control group was treated with craniotomy clipping by pterion approach,and the observation group was treated with craniotomy clipping by lateral supraorbital approach.The treatment effect,intraoperative blood loss,operative time,hospital stay,complication rate,before and after surgery of neurological function scores[national institutes of health stroke scale(NIHSS)score],nerve injury indexes[neuron specific enolase(NSE),S100 calcium-binding protein B(S100B)and myelin basic protein(MBP)]and traumatic stress indexes[β-endorphin(β-EP),interleukin-6(IL-6)and dynorphin A1-13(DynA1-13)]were compared between two groups.Result:Three months after operation the total effective rate of the observation group was significantly higher than that of the control group,the intraoperative blood loss was significantly lower than that of the control group,and the operation time and hospital stay were significantly shorter than those of the control group,the differences were statistically significant(P<0.05).There were no significant differences in the incidence of complications between two groups(P>0.05).There were no significant differences in NIHSS scores,nerve injury indexes and traumatic stress indexes between two groups before surgery(P>0.05).Seven days after operation,the NIHSS scores,nerve injury indexes and traumatic stress indexes in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Craniotomy clipping by lateral supraorbital approach has good clinical effect in the treatment o

关 键 词：眶上额外侧入路 翼点入路 开颅夹闭 前循环动脉瘤破裂 

分 类 号：R651.12[医药卫生—外科学]