经眶上外侧入路治疗前循环破裂动脉瘤

目的探讨应用眶上外侧入路显微外科手术夹闭前循环破裂动脉瘤的临床疗效和手术技巧。方法收集我科20例应用眶上外侧入路行前循环破裂动脉瘤夹闭术患者的临床资料进行分析。术前按照Hunt-Hess分级Ⅰ~Ⅲ级以及改良CT Fisher分级Ⅱ~Ⅲ级作为入选标准,术后以格拉斯哥结果评分(GOS)评价手术效果。结果 20个动脉瘤均一次夹闭成功。根据GOS评估标准,恢复良好者18例,轻残2例。所有病例无术后感染、面神经损伤、出血及脑脊液漏等手术并发症。结论眶上外侧入路是一种安全而有效的微创手术入路,适宜在低分级的前循环破裂动脉瘤夹闭术中应用。

Treatment of ruptured aneurysms of anterior circulation by microsurgery via lateralsupraorbital approach

Objective To study therapeutic effect of microsurgery via lateral supraorbital （LSO） approach on ruptured aneurysms of anterior circulation and its techniques. Methods The clinical data of 20 patients with low grade ruptured aneurysms of anterior circulation who treated with microsurgery via LSO approach in our department were analyzed retrospectively. All patients were at Hunt-Hess I-m and Improved Fisherg Scale I] - m before anatomy. The neurological functions were scored according to GOS. Results Total 20 aneurysms were clipped successfully in one operation via LSO approach. Outcome was considered according to GOS as good recovery in 18 patients and mild disability in 2. There was no temporal muscle atrophy, bleeding, CSF leakage and injury of the upper branch of the facial never after operations. Conclusion Microsurgery via LSO approach is a safe, minimally invasive and effective way for the treatment of low grade ruptured aneurysms of anterior circulation.