眶上锁孔入路显微手术治疗前循环动脉瘤

目的 探讨眶上锁孔人路、神经内镜辅助显微手术治疗前循环动脉瘤的手术方法。方法 对12例前循环动脉瘤患者,依据手术前诊断性影像资料,制订个体化手术计划;手术行眉部皮肤切口,于眶上作直径2cm左右骨窗开颅,采用内镜辅助的显微外科技术夹闭动脉瘤。结果 12例5种不同类型动脉瘤患者经该方法治愈,其中1例患者术中动脉瘤破裂,经阻断载瘤动脉12min,妥善分离动脉瘤后,在内镜辅助下准确夹闭瘤颈,术后对侧肢体有暂时性轻瘫,经治疗1周后肌力恢复正常。本组病例均未出现与手术人路相关的并发症。结论 采用眶上锁孔入路、内镜辅助的显微外科技术治疗前循环动脉瘤,是一种安全、微侵袭和有效的途径。

Supraorbital keyhole approach for microsurgical treatment of aneurysms in the anterior circulation

Objective To study the method with endoscope assisted microsurgical technique through the supraorbital keyhole approach to treat aneurysms in the anterior circulation. Methods According to preoperative diagnostic imagings, to work out of the individual operation planning. Skin incision was made in the eyebrow, and the diameter of supraorbital craniotomy was about 2 cm, endoscope assisted microsurgical technique was used to clip aneusysm. The technique was used in the most recent 12 consecutive patients. Results Five different kinds of aneurysms in the aterior circulation were clipped through this method and 12 patients were cured. One patient, intraoperative accidental aneurysm rupture occurred. There were no approach related complications. Conclusions This endoscope assisted microsurgical technique via supraorbital keyhole approach is a safe, minimal invasive and effective way for the treatment of aneurysms in the aterior circulation,and there is more sufficicent operating space.