经眉弓眶上锁孔入路手术治疗前循环动脉瘤

目的探讨前循环动脉瘤经眉弓眶上锁孔入路手术夹闭的方法及相对适应证。方法分析我科用该手术方式治疗的14例(16个)颅内前循环动脉瘤的临床资料,着重阐述手术方法、注意事项、术中动脉瘤破裂处理及手术适应证。结果14例(16个)动脉瘤全部一次手术夹闭成功,其中4例术中有动脉瘤破裂出血,2例合并有脑积水并行脑室腹腔分流术,1例死于肺部感染及多脏器功能衰竭,其它患者恢复良好。结论用该方法治疗前循环动脉瘤安全、微创,值得临床推广应用。

Trans-superciliary arch supraorbital keyhole approach for microsurgical treatment of aneurysms in anterior circulation

Objective To study the methods and indications of microsurgical treatment via trans-superciliary arch supraorbital keyhole approach for aneurysms in the anterior circulation. Methods The clinical data of 14 cases (16 aneurysms) treated with microsurgery via trans-superciliary arch supraorbital keyhole approach were analyzed, focusing on their operative procedures, skills, dealing with the ruptured aneurysms and indications. Results All 16 aneurysms of different types in the anterior circulation were clipped successfully through this method. Intraoperative accidental aneurysm rupture occurred in 4 cases. Two patients underwent ventriculoperitoneal shunt due to hydrocephaly; one patient died of pneumonia and multiorgan dysfunction syndrome. There were no approach-related complications. Conclusion Microsurgery via trans-superciliary arch supriaorbital keyhole approach is a safe, minimally invasive and effective way for the treatment of aneurysms in the anterior circulation.