颅内前循环破裂动脉瘤急性期经额外侧入路锁孔手术的疗效分析

目的 探讨颅内前循环破裂动脉瘤急性期（72 h内）经额外侧入路锁孔手术治疗的疗效。方法 回顾性分析2018年8月至2022年8月经额外侧入路锁孔手术治疗的28例大脑前循环破裂动脉瘤的临床资料，均在发病72 h内手术。结果 术后1周复查头颈部CTA显示28例颅内动脉瘤均夹闭完全。术后4例出现脑缺血表现。术后无颅内感染、脑脊液漏、颅内血肿等并发症。术后4～6个月复查头颅CT、CTA或DSA，无新发脑梗死、脑积水，无动脉瘤复发；按GOS评分评估预后：恢复良好26例，中残2例。结论 颅内前循环破裂动脉瘤急性期经额外侧入路锁孔手术治疗，可减少手术创伤，手术效果良好。

Outcomes of keyhole surgery via lateral frontal approach for ruptured anterior circulating aneurysms at acute stage

Objective To investigate the outcomes of keyhole surgery via the lateral frontal approach for patients with ruptured anterior circulating aneurysms at acute stage (within 72 hours). Methods The clinical data of 28 patients with ruptured anterior circulating aneurysms who underwent keyhole surgery through the lateral frontal approach at acute stage from August 2018 to August 2022 were retrospectively analyzed. Results CTA reexamination one week after the surgery showed that the intracranial aneurysms were clipped completely in all patients. Ischemic stroke occurred in 4 patients after the operation. There were no intracranial infection, cerebrospinal fluid leakage, and intracerebral hematoma. CT, CTA, or DSA were reexamined 4 to 6 months after the surgery, and no new cerebral infarction, hydrocephalus, or aneurysm recurrence were found. A GOS score of 5 was achieved in 26 patients, and a score of 4 in 2. Conclusions Keyhole surgery via the lateral frontal approach can reduce surgical trauma and achieve good outcomes for patients with ruptured anterior circulating aneurysms at acute stage.