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中华脑科疾病与康复杂志(电子版)

中华脑科疾病与康复杂志(电子版) ›› 2020, Vol. 10 ›› Issue (01) : 34 -37. doi: 10.3877/cma.j.issn.2095-123X.2020.01.008

所属专题： 文献；

短篇论著

经眶上外侧入路与经翼点入路治疗前循环动脉瘤破裂的疗效分析
周顺义1,†(), 郑全乐1, 张家瑞1, 李春虎1, 尹雅丽1, 张同乐1   
  1. 1. 065000　河北廊坊，廊坊爱德堡医院神经外科
  • 收稿日期:2019-10-08 出版日期:2020-02-15
  • 通信作者: 周顺义

Efficacy analysis of supraorbital lateral approach in the treatment of acute anterior circulation aneurysm rupture patients

Shunyi Zhou1,†(), Quanle Zheng1, Jiarui Zhang1, Chunhu Li1, Yali Yin1, Tongle Zhang1   

  1. 1. Department of Neurosurgery, Langfang Edberg Hospital, Langfang 065000, China
  • Received:2019-10-08 Published:2020-02-15
  • Corresponding author: Shunyi Zhou
  • About author:
    Corresponding author: Zhou Shunyi, Email:
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周顺义, 郑全乐, 张家瑞, 李春虎, 尹雅丽, 张同乐. 经眶上外侧入路与经翼点入路治疗前循环动脉瘤破裂的疗效分析[J]. 中华脑科疾病与康复杂志(电子版), 2020, 10(01): 34-37.

Shunyi Zhou, Quanle Zheng, Jiarui Zhang, Chunhu Li, Yali Yin, Tongle Zhang. Efficacy analysis of supraorbital lateral approach in the treatment of acute anterior circulation aneurysm rupture patients[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2020, 10(01): 34-37.

目的

探讨经眶上外侧入路治疗前循环颅内动脉瘤（IA）破裂急性期患者的疗效分析。

方法

选取自2016年2月至2019年6月于爱德堡医院神经外科进行治疗的前循环IA急性期患者60例，根据随机分组的原则分为经翼点入路组（WA组）和眶上外侧入路组（UA组），每组30例。WA组患者采用经翼点入路的手术方法进行治疗，UA组采用经眶上外侧入路的手术方法进行治疗。分析2组患者的临床指标、治疗效果。

结果

手术过程中，WA组患者术中出血量[（164.81±24.13）mL]、切口长度[（18.59±2.04）cm]、手术时间[（182.35±21.75）min]均高于UA组[（101.25±25.76）mL、（9.89±1.12）cm、（131.08±17.58）min]，差异具有统计学意义（P<0.05）。WA组患者22例恢复良好，UA组患者23例恢复良好，2组均未出现死亡，UA组恢复良好率优于WA组（P>0.05）。WA组8例患者出现并发症，UA组2例患者出现并发症，UA组并发症发生率低于WA组（P<0.05）。

结论

经眶上外侧入路手术方法与传统手术方法相比较，前者治疗前循环IA效果更佳、预后良好、并发症发生率较低。

关键词: 颅内动脉瘤, 前循环, 经眶上外侧入路
Objective

To explore the therapeutic effect of supraorbital lateral approach in the treatment of acute anterior circulation intracranial aneurysm (IA) rupture.

Methods

Sixty patients with anterior circulation IA acute phase who were treated in neurosurgery department of Langfang Edberg Hospital from February 2016 to June 2019 were selected. According to the principle of random grouping, it is divided into trans-wing point approach group (WA group) and supraorbital lateral approach group (UA group), 30 cases in each group. WA group were treated by wing-point approach, UA group was treated by supraorbital lateral approach. The clinical indicators and treatment effects of two groups were analyzed.

Results

During the operation, the intraoperative blood loss [(164.81±24.13) mL], incision length [(18.59±2.04) cm], operation time [(182.35±21.75) min] of WA group were higher than that of UA group [(101.25±25.76) mL, (9.89±1.12) cm, (131.08±17.58) min], the differences were statistically significant (P<0.05). Twenty-two patients in WA group recovered well, 23 patients in UA group recovered well, and no death occurred in either group. The recovery rate of UA group was better than that of WA group (P>0.05). Eight patients in WA group had complications, and 2 patients in UA group had complications. The incidence of complications in UA group was lower than that in WA group (P<0.05).

Conclusion

Compared with the traditional surgical methods, the supraorbital lateral approach has better therapeutic effect, better prognosis and lower complication rate.

Key words: Intracranial aneurysm, Anterior circulation, Supraorbital lateral approach
表1 2组患者一般资料比较
因素 WA组(n=30) UA组(n=30) χ2/t值 P值
性别 ? ? 0.030 0.862
? 男 16 17 ? ?
? 女 14 13 ? ?
Hunt-Hess分级 ? ? 0.286 0.592
? Ⅰ 6 8 ? ?
? Ⅱ 8 11 ? ?
? Ⅲ 16 11 ? ?
合并疾病 ? ? 0.059 0.808
? 高血压 8 9 ? ?
? 糖尿病 9 13 ? ?
? 意识障碍 12 11 ? ?
? 癫痫 14 9 ? ?
? 其他 10 12 ? ?
年龄（Mean±SD，岁） 45.18±9.68 46.32±9.28 0.465 0.643
发病时间（Mean±SD，d） 2.29±0.33 2.31±0.35 0.227 0.820
表2 2组患者临床指标比较（Mean±SD）
组别 例数 切口长度(cm) 手术时间(min) 术中出血量(mL)
WA组 30 18.59±2.04 182.35±21.75 164.81±24.13
UA组 30 9.89±1.12 131.08±17.58 101.25±25.76
t值 ? 20.481 10.040 9.862
P值 ? <0.001 <0.001 <0.001
表3 2组患者疗效比较
组别 例数 恢复良好 轻度残疾 重度残疾 植物生存 良好率(%)
WA组 30 22 5 1 2 73.33
UA组 30 23 6 0 1 76.67
χ2值 ? ? ? ? ? 0.063
P值 ? ? ? ? ? 0.802
表4 2组患者并发症情况比较
组别 例数 颅内感染 脑脊液漏出 颞肌萎缩 面神分支损伤 发生率(%)
WA组 30 3 5 0 2 33.33
UA组 30 0 1 0 1 6.67
χ2值 ? ? ? ? ? 17.769
P值 ? ? ? ? ? <0.001
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