经眉弓-眶上入路手术夹闭前交通动脉瘤的临床疗效分析

目的讨论经眉弓-眶上入路治疗前交通动脉瘤的手术方法和治疗效果。方法回顾性分析我院一年期间采用经眉弓-眶上入路治疗前交通动脉瘤18例的临床资料,介绍经眉弓-眶上入路的手术方法。入组资料中,按Hunt-Hess分级,其中Ⅰ级3例,Ⅱ级7例,Ⅲ级6例,Ⅳ级2例。结果 18例动脉瘤均成功夹闭。根据GOS疗效判断标准:预后良好14例(77.8%),中残2例(11.1%),重残1例(5.5%),死亡1例(5.5%)。结论应用经眉弓-眶上入路夹闭前交通动脉瘤可以利用更低的角度,由脑外间隙处理前交通动脉瘤,可作为前交通动脉瘤的一种手术入路的选择。

A clinical analysis of trans-supraorbital approach for anterior communicating artery aneurysms

Objective To explore the operative technique of trans-supraorbital approach to anterior communicating artery aneurysms and its curative effect .Methods The clinical data of 18 patients with anterior communicating artery aneurysms treated through trans -supraorbital approach in our hospital were analyzed retrospectively .The operating technique was described .According to Hunt-Hess grade,the number of patients with gradeⅠ,Ⅱ,Ⅲ and Ⅳ were 3,7,6 and 2.Results The aneurysms were succesfully clipped in all the patients .According to GOS grade ,14 cases （77.8%） recovered with good outcome ,2 （11.1%） with moderate disability , 1 （5.5%） with severe disability and 1 （5.5%） with death.Conclusion The anterior communicating artery complex can be reached through the trans-supraorbital approach from a more ventral access and extracerebral gap , which be regarded as one of operating approaches to the anterior communicating artery aneurysms .