眶外侧锁孔入路夹闭破裂的微小前交通动脉瘤

目的探讨经眶外侧微骨孔入路夹闭破裂的微小前交通动脉瘤手术技巧与临床意义。方法自2011年1月至2014年12月破裂的微小前交通动脉瘤患者48例,分析检查方法、影像学特征、诊治过程及手术效果。结果均成功夹闭动脉瘤瘤颈,其中术中破裂16例,恢复良好36例;生活能自理9例;扶拐行走,需人照顾3例。其中39例随访3~36个月,无再出血与死亡病例。结论眶外侧锁孔入路显微手术治疗微小前交通动脉瘤具有简捷、快速、微创的优点,对于顺利夹闭破裂的微小型前交通动脉瘤、预防和控制术中破裂出血尤为重要。

Lateralorbital k eyhole approach for microsurgical treatment of ruptured tinyanterior communicating aneurysms

Objective To investigate the clinical application and surgical techniques of lateral-orbital keyhole approach to clip ruptured tiny anterior communicating aneurysms.Methods A retrospective analysis was performed on the clinical data of 48 patients with ruptured tiny anterior communicating aneurysms, including examination methods, imaging features, diagnosis and treatment process , and operation effect, which underwent lateral orbital keyhole approach from January 2011 to December 2014.Results Among 48 patients with a total of 51 aneurysms, all achieved successful clipping with a rupture rate of 31.4%(16cases).36 cases got good recovery, 9 cases owned the self-care ability, and 3 cases could carry out daily lives with help.There was no rebleeding and mortality, according to a 3-36 months follow-up of 39 patients.Conclusion As a surgical approach for willis cycle aneurysm, the lateral orbital approach is simple, rapid, minimally-invasive way.It is available in the clipping of ruptured tiny anterior communicating aneurysms, will be the keypoint of clipping aneurysms, preventing and controlling of intraoperative bleeding.