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

目的 探讨眶上外侧入路与经典翼点入路手术治疗急性期颅内前循环破裂动脉瘤的临床效果。方法 2012年11月至2014年5月收治74例急性期前循环破裂动脉瘤，采用眶上外侧入路手术37例（眶上外侧组），采用经典翼点入路37例（翼点组）。结果 眶上外侧组手术时间[（138.9±15.9）min]、切口长度[（9.4±1.6）cm]、术中出血量[（52.6±5.9）ml]较翼点组均明显减少[分别为（174.8±22.6）min、（15.7±2.6）cm、（236.8±25.8）ml；P<0.05]。眶上外侧组术中动脉瘤破裂率（16.2%，6/37）和翼点组（18.9%，7/37）无明显差异（P>0.05）。结论 相比经典翼点入路，眶上外侧入路手术治疗急性期前循环破裂动脉瘤手术创伤较小。

Microsurgery for ruptured intracranial anterior circulation aneurysms at acute stage: supraorbital lateral approach vs. pterional approach

Objective To compare the clinical effect of microsurgery via supraorbital lateral approach (SOLA) on ruptured intra- cranial anterior circulation aneurysms (RIACA) with that of microsurgery via pterional approach (PA). Methods Seventy four patients with RIACA at acute stage treated from November, 2012 to May, 2014 were randomly divided into two groups, i.e. observed group, in which 37 underwent microsurgery via SOLA and control group, in which 37 via PA. The clinical effects on RIACA were compared between both the groups. Results The operating duration, length of operative cut and volume of intraoperative bleeding were significantly less in the observed group than those in the control group (P<0.05). The percentages of the patients undergoing removal of bone flaps and receiving intraopertive transfusion of blood were significantly lower in the observed group than those in the control group (P<0.05). Conclusion The clinical effect of microsurgery via SOLA at acute stage, which can decrease the operation side injury, on RIACA is good.