[1]王玉贵 李朝晖 郭永川 贾翊平 梁世鹏 刘德华.眶上外侧入路与翼点入路显微手术治疗急性期前循环破裂动脉瘤的对比分析[J].中国临床神经外科杂志,2016,(08):452-454.[doi:10.13798/j.issn.1009-153X.2016.08.002]
 WANG Yu-gui,LI Chao-hui,GUO Yong-chuan,et al.Microsurgery through lateral supraorbital approach for acute ruptured anterior circulation aneurysms[J].,2016,(08):452-454.[doi:10.13798/j.issn.1009-153X.2016.08.002]
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眶上外侧入路与翼点入路显微手术治疗急性期前循环破裂动脉瘤的对比分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2016年08期
页码:
452-454
栏目:
论著
出版日期:
2016-08-18

文章信息/Info

Title:
Microsurgery through lateral supraorbital approach for acute ruptured anterior circulation aneurysms
文章编号:
1009-153X(2016)08-0452-03
作者:
王玉贵 李朝晖 郭永川 贾翊平 梁世鹏 刘德华
130031 长春,吉林大学中日联谊医院神经外二科
通讯作者:刘德华,E-mail:ldh1676@163.com
Author(s):
WANG Yu-gui LI Chao-hui GUO Yong-chuan JIA Yi-ping LIANG Shi-peng LIU De-hua.
Department of Neurosurgery, China-japan Union Hospital, Jilin University, Changchun 130031, China
关键词:
颅内破裂动脉瘤前循环显微手术眶上外侧入路翼点入路
Keywords:
Microsurgery Lateral supraorbital approach Anterior circulation aneurysms Clinical effect
分类号:
R 743.9; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2016.08.002
文献标志码:
A
摘要:
目的 探讨眶上外侧入路与翼点入路显微手术治疗急性期前循环破裂动脉瘤的疗效。方法 2014年3月至2015年9月采用显微手术治疗Hunt-Hess分级Ⅰ~Ⅲ级急性期前循环破裂动脉瘤81例,经眶上外侧入路夹闭43例(观察组),翼点入路夹闭38例(对照组)。结果 观察组手术时间[(152.7±19.1)min]、手术切口长度[(9.1±0.9)cm]、住院时间[(12.3±3.6)d]较对照组[分别为(182.4±26.6)min、(15.1±1.1)cm、(15.3±2.8)d]均明显减少(P<0.01)。两组术后3个月gos评分无统计学差异(>P>0.05)。结论 眶上外侧入路创伤小、手术时间短、术后恢复快,治疗Hunt-Hess分级低级别急性期前循环破裂动脉瘤手术效果良好。
Abstract:
Objective To explore the clinical effect of the microsurgery through lateral supraorbital approach (LSOA) on acute ruptured anterior circulation aneurysms. Methods The clinical data of 81 patients with ruptured anterior circulation aneurysms (Hunt-Hess gradeⅠto Ⅲ), of whom, 43 (observed group) underwent microsurgery through LSOA and 38 (control group) through pterional approach from March, 2014 to September, 2015, were analyzed retrospectively. Results The operative time [(152.7±19.1) min], length of operative cut [(9.1±0.9) cm] and hospital stay [(12.3±3.6) d] were significantly shorter in the observed group than those [(182.4±26.6) min, (15.1±1.1) cm and (15.3±2.8) d, respectively] in the control group (P<0.01). there="" was="" insignificant="" difference="" in="" gos="" scores="" between="" both="" the="" groups="" (P>0.05). Conclusion The microsurgery through LSO should be recommended in the patients with ruptured anterior circulation aneurysms because it has the advantages such as shorter operative time, less injury and rapid recovery.

参考文献/References:

[1] Heller RS, Lawlor CM, Hedges TR 3rd, et al. Neuroophthal- mic effects of stenting across the ophthalmic artery origin in the treatment of intracranial aneurysms [J]. J Neurosurg, 2014, 12l(1): 18-23.
[2] 刘庆良. 神经外科手术入路解剖与临床[M]. 第1版. 北 京:中国科学技术出版社,2007. 85-91.
[3] 郑鉴峰,郭宗铎,张晓冬,等. 开颅夹闭术和血管内栓塞术 治疗老年前交通动脉破裂动脉瘤的疗效对比分析[J]. 中 国临床神经外科杂志,2016,21:150-151,154.
[4] 赵 平,王雄伟,汪 雷,等. 显微手术和血管内栓塞术治 疗颅内动脉瘤的疗效分析[J]. 中国临床神经外科杂志, 2016,21:281-282,316.
[5] Hernesniemi J, Ishii K, Niemela M, et al. Lateral supraor- bital approach as an alternative to the classical pterional approach [J]. Acta Neurochir Suppl, 2005, 94: 17-21.
[6] Cha KC, Hong SC, kim JS, et al. Comparison between lateral supraorbital approach and pterional approach in the surgical treatment of unruptured intracranial aneurysms [J]. J Korean Neurosurg Soc, 2012, 51(6): 334-337.
[7] 殷义明,陈罡,王 中,等. 眶上外侧入路在鞍区肿瘤显微 手术中的评估[J]. 中华医学杂志,2014,94(25):1956- 1959.
[8] 秦 冰,应广宇,胡 华,等. 经眶上外侧入路夹闭颅内前 循环动脉瘤的临床应用[J]. 浙江大学学报:医学版, 2015,44(4):383-388.
[9] Salma M, Alkandari A, Sammet S, et al. Lateral supraorbital approach vs pterional approach: an anatomic qualitative and quantitative evaluation[J]. Neurosurgery, 2011, 68(2): 364- 371.
[10] 束旭俊,孙正辉,武 琛,等. 颅内多发动脉瘤的手术治疗 [J]. 中华外科杂志,2015,53(2):145-148.
[11] Yang TC, Chang CH, Liu YT, et al. Predictors of shunt-de- pendent chronic hydrocephalus after aneurysmal subarach- noid haemorrhage [J]. Eur Neurol, 2013, 69(5): 296-303.
[12] 彭世维,漆松涛,冯文峰,等.脑池及脑池积血在动脉瘤性 蛛网膜下腔出血后急性脑积水发生中的作用[J]. 中华神 经外科杂志,2015,31(7):697-701.

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更新日期/Last Update: 2016-08-19