[1]杨涛,王向东,郭铁柱.颅内前循环破裂动脉瘤急性期经额外侧入路锁孔手术的疗效分析[J].中国临床神经外科杂志,2023,28(02):77-79.[doi:10.13798/j.issn.1009-153X.2023.02.004]
 YANG Tao,WANG Xiang-dong,GUO Tie-zhu.Outcomes of keyhole surgery via lateral frontal approach for ruptured anterior circulating aneurysms at acute stage[J].,2023,28(02):77-79.[doi:10.13798/j.issn.1009-153X.2023.02.004]
点击复制

颅内前循环破裂动脉瘤急性期经额外侧入路锁孔手术的疗效分析()
分享到:

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
28
期数:
2023年02期
页码:
77-79
栏目:
论著
出版日期:
2023-02-28

文章信息/Info

Title:
Outcomes of keyhole surgery via lateral frontal approach for ruptured anterior circulating aneurysms at acute stage
文章编号:
1009-153X(2023)02-0077-03
作者:
杨涛王向东郭铁柱
046000山西长治,长治医学院附属和济医院神经外科(杨涛、王向东、郭铁柱)
Author(s):
YANG Tao WANG Xiang-dong GUO Tie-zhu
Department of Neurosurgery, Department of Neurosurgery, Heji Hospital Affiliated to Changzhi Medical College, Changzhi 046000, China
关键词:
颅内破裂动脉瘤前循环动脉瘤急性期夹闭术锁孔手术额外侧入路疗效
Keywords:
Intracranial ruptured aneurysm Anterior circulation aneurysm Acute stage Clipping Keyhole surgery Lateral frontal approach
分类号:
R743.9;R651.1+2
DOI:
10.13798/j.issn.1009-153X.2023.02.004
文献标志码:
A
摘要:
目的 探讨颅内前循环破裂动脉瘤急性期(72 h内)经额外侧入路锁孔手术治疗的疗效。方法 回顾性分析2018年8月至2022年8月经额外侧入路锁孔手术治疗的28例大脑前循环破裂动脉瘤的临床资料,均在发病72 h内手术。结果 术后1周复查头颈部CTA显示28例颅内动脉瘤均夹闭完全。术后4例出现脑缺血表现。术后无颅内感染、脑脊液漏、颅内血肿等并发症。术后4~6个月复查头颅CT、CTA或DSA,无新发脑梗死、脑积水,无动脉瘤复发;按GOS评分评估预后:恢复良好 26例,中残2例。结论 颅内前循环破裂动脉瘤急性期经额外侧入路锁孔手术治疗,可减少手术创伤,手术效果良好。
Abstract:
Objective To investigate the outcomes of keyhole surgery via the lateral frontal approach for patients with ruptured anterior circulating aneurysms at acute stage (within 72 hours). Methods The clinical data of 28 patients with ruptured anterior circulating aneurysms who underwent keyhole surgery through the lateral frontal approach at acute stage from August 2018 to August 2022 were retrospectively analyzed. Results CTA reexamination one week after the surgery showed that the intracranial aneurysms were clipped completely in all patients. Ischemic stroke occurred in 4 patients after the operation. There were no intracranial infection, cerebrospinal fluid leakage, and intracerebral hematoma. CT, CTA, or DSA were reexamined 4 to 6 months after the surgery, and no new cerebral infarction, hydrocephalus, or aneurysm recurrence were found. A GOS score of 5 was achieved in 26 patients, and a score of 4 in 2. Conclusions Keyhole surgery via the lateral frontal approach can reduce surgical trauma and achieve good outcomes for patients with ruptured anterior circulating aneurysms at acute stage.

参考文献/References:

[1]宋朝理,郑小强,庄进学,等. 一期治疗颅内多发动脉瘤的临床分析[J]. 中国临床神经外科杂志,2014,19(3):148-149.
[2]薛洪利,孙荣君,闻 华,等. 一期锁孔手术治疗大脑前循环多发动脉瘤[J]. 中国临床神经外科杂志,2018,23(9):598-599.
[3]许志剑,陈云祥,陈俊良,等. 改良眶上入路结合脑室外引流术治疗前循环动脉瘤[J]. 中国微侵袭神经外科杂志,2018,23(4):172-174.
[4]Kin S, Kang M, Choi JH, et al. Safety of coil occlusion of the parent artery for endovascular treatment of anterior communicating artery aneurysm [J]. Neuroradiol J, 2016, 29(3): 201-207.
[5]Steiger HJ, Etminan N, Hnggi D. Aneurysms of the Anterior Cerebral Artery [M]. Microsurgical Brain Aneurysms. Berlin Heidelberg: Springer, 2015. 67-79.
[6]Yasargil MG, Antic J, Laciga R, et al. Microsurgical pterional approach to aneurysms of the basilar bifurcation [J]. Surg Neurol, 1976, 6(2): 83-91.
[7]杨亦春,倪世慧,杨秀环,等. 多锁孔入路下前交通动脉复合体的解剖学研究[J]. 中国医师进修杂志,2013,(29):62-64.
[8]赵庚水,黄 楹. 经缩小额外侧入路治疗前循环动脉瘤的临床分析[J]. 天津医科大学学报,2015,21(1):65-67.
[9]Salma A, Alkandari A, Sammet S, et al. Lateral supraorbital approach vs pterional approach:an annatomic qualitative and quantitative evaluation [J]. Neurosurgery, 2011, 68(3-4): 364.
[10]王红光,王世波,方占海,等. 单侧额外侧锁孔入路显微手术治疗双侧前循环动脉瘤的临床疗效观察[J]. 中国神经外科杂志,2021,37(1):64-67.

相似文献/References:

[1]张晓燕 张 穗 宋利亚.颅内破裂动脉瘤急诊夹闭术围手术期护理[J].中国临床神经外科杂志,2016,(05):308.[doi:10.13798/j.issn.1009-153X.2016.05.019]
[2]伍 杰 杨 铭 潘 力 蔡明俊 刘 鹏 秦 杰 杨 柳 安学锋 李国栋 马廉亭.颅内破裂动脉瘤合并脑内血肿的复合手术治疗[J].中国临床神经外科杂志,2016,(04):193.[doi:10.13798/j.issn.1009-153X.2016.04.001]
 WU Jie,YANG Ming,PAN Li,et al.Clinical observation of hybrid surgery on ruptured intracranial aneurysms associated with cerebral hematomas (report of 5 cases)[J].,2016,(02):193.[doi:10.13798/j.issn.1009-153X.2016.04.001]
[3]符传艺 陈健龙 张 茂 刘朝晖 黄垂学 黄 军 马建荣 赵建农.表现为脑室出血的颅内破裂动脉瘤的诊治[J].中国临床神经外科杂志,2016,(04):234.[doi:10.13798/j.issn.1009-153X.2016.04.014]
[4]郑鉴峰 郭宗铎 张晓冬 朱 继 何朝晖 孙晓川.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,(03):150.[doi:10.13798/j.issn.1009-153X.2016.03.006]
 ZHENG Jian-feng,GUO Zong-duo,ZHANG Xiao-dong,et al.Craniotomy clipping and interventional treatment of ruptured anterior communicating artery aneurysms in elderly patients: comparison of curative effects[J].,2016,(02):150.[doi:10.13798/j.issn.1009-153X.2016.03.006]
[5]李玉龙 方兴根 李真保 吴德刚 赖年升 赵心同 徐善水 狄广福.血管内治疗颈内动脉床突旁破裂动脉瘤[J].中国临床神经外科杂志,2016,(02):79.[doi:10.13798/j.issn.1009-153X.2016.02.006]
 LI Yu-long,FANG Xing-gen,LI Zhen-bao,et al.Endovascular embolization of ruptured paraclinoid aneurysms (report of 26 cases)[J].,2016,(02):79.[doi:10.13798/j.issn.1009-153X.2016.02.006]
[6]胡 骁 周林裕 王 克 邓剑平 赵振伟.支架辅助血管内栓塞前交通动脉破裂动脉瘤的疗效[J].中国临床神经外科杂志,2016,(02):82.[doi:10.13798/j.issn.1009-153X.2016.02.007]
 HU Xiao,ZHOU Lin-yu,WANG Ke,et al.Curative effect of stent-assisted endovascular embolization on ruptured anterior communicating artery aneurysms[J].,2016,(02):82.[doi:10.13798/j.issn.1009-153X.2016.02.007]
[7]申汉威 李俊卿 李红星 汪立刚 杨孔宾.颅内破裂动脉瘤夹闭术与血管内栓塞术后脑积水发生率的比较分析[J].中国临床神经外科杂志,2015,(03):140.[doi:10.13798/j.issn.1009-153X.2015.03.004]
 SHEN Han-wei,LI Jun-qing,LI Hong-xing,et al.Clinical study and Meta-analysis of incidences of hydrocephalus after microsurgery and endovascular embolization in patients with ruptured intracranial aneurysms[J].,2015,(02):140.[doi:10.13798/j.issn.1009-153X.2015.03.004]
[8]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.[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,(02):452.[doi:10.13798/j.issn.1009-153X.2016.08.002]
[9]邓民强 潘 轲 田仁富 王国堰 向春晖.眶上外侧入路与翼点入路手术治疗急性期颅内前循环破裂动脉瘤的临床对比分析[J].中国临床神经外科杂志,2016,(10):606.[doi:10.13798/j.issn.1009-153X.2016.10.012]
 DENG Min-qiang,PAN Ke,TIAN Ren-fu,et al.Microsurgery for ruptured intracranial anterior circulation aneurysms at acute stage: supraorbital lateral approach vs. pterional approach[J].,2016,(02):606.[doi:10.13798/j.issn.1009-153X.2016.10.012]
[10]李 明,党 伟,胡志卿,等.早期栓塞和手术夹闭颅内破裂动脉瘤的疗效及安全性[J].中国临床神经外科杂志,2016,(12):759.[doi:10.13798/j.issn.1009-153X.2016.12.009]
 LI Ming,DANG Wei,HU Zhi-qing,et al.Evaluation of effect of early interventional treatment on ruptured incranial aneurysms and its safety[J].,2016,(02):759.[doi:10.13798/j.issn.1009-153X.2016.12.009]
[11]李东波 刘 锋 王亚萍 杨 帆 金 涛 李 海 王茂德.前循环破裂动脉瘤的显微外科治疗[J].中国临床神经外科杂志,2017,(05):343.[doi:10.13798/j.issn.1009-153X.2017.05.022]

备注/Memo

备注/Memo:
(2022-11-27收稿,2022-01-27修回)
通讯作者:王向东,E-mail:www.448272775@qq.com
更新日期/Last Update: 2022-03-31