Clinical comparative analysis of supraorbital lateral approach and pterional approach for acute intracranial anterior circulation ruptured aneurysms

doi:10.3877/cma.j.issn.2095-123X.2019.04.007

Abstract

Abstract:

Objective

To study the effect of supraorbital lateral approach and pterional approach on acute intracranial anterior circulation ruptured aneurysms.

Methods

Eighty-four patients with ruptured intracranial anterior circulation aneurysms in the acute period were admitted to our hospital from November 2017 to June 2019 were selected as the research objects. The patients were randomly divided into observation group (supraorbital lateral approach surgery) and control group (pterional approach surgery) with 42 cases in each group. The change time and effective rate of clinical indicators in the two groups were evaluated.

Results

There was no significant difference in preoperative quality of life between the two groups (P>0.05). After operation, the physiological field, physical limitation, social field and scores of mental state in the observation group were higher than those in the control group(P<0.05). The operation time and hospitalization time are shorter than those of the control group, the incision length is smaller than that of the control group, and the intraoperative blood loss is less than that of the control group (P<0.05). The effective rate of observation operation (97.61%) was higher than that of control group (85.71%), while the complication rate of observation group (9.52%) was lower than that of control group (28.57%) (P<0.05). The levels of IL-12p70, IFN-γ and TNF-α in the two groups were significantly higher than those before operation (P<0.05). However, the levels of IL-12p70, IFN-γ and TNF-α in the observation group were significantly lower than those in the control group (P<0.05).

Conclusion

Compared with pterional approach, supraorbital lateral approach for acute intracranial anterior circulation ruptured aneurysms can improve the quality of life and surgical effect.

Key words: Ruptured aneurysms of intracranial anterior circulation in acute stage, Supraorbital lateral approach, Pterional approach

Quanle Zheng, Hao Zhao, Jiarui Zhang, Chunhu Li, Shunyi Zhou, Tongle Zhang. Clinical comparative analysis of supraorbital lateral approach and pterional approach for acute intracranial anterior circulation ruptured aneurysms[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2019, 09(04): 218-221.

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References 15

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组别	例数	手术时间（min）	切口长度（cm）	术中出血量（mL）	住院时间（d）
观察组	42	152.68±19.14	9.15±0.94	52.61±5.83	12.28±3.35
对照组	42	182.41±26.53	15.17±1.16	236.71±25.84	15.34±2.79
t值	?	5.890	26.130	45.041	4.549
P值	?	0.000	0.000	0.000	0.000

组别	例数	手术时间（min）	切口长度（cm）	术中出血量（mL）	住院时间（d）
观察组	42	152.68±19.14	9.15±0.94	52.61±5.83	12.28±3.35
对照组	42	182.41±26.53	15.17±1.16	236.71±25.84	15.34±2.79
t值	?	5.890	26.130	45.041	4.549
P值	?	0.000	0.000	0.000	0.000

项目	?	观察组（n=42）	对照组（n=42）	t值	P值
?	术前	75.48±5.28	75.36±5.14	0.106	0.916
生理领域	术后	89.27±7.39	82.15±7.02	4.527	0.000
生理领域	t值	9.840	5.058	?	?
?	P值	0.000	0.000	?	?
?	术前	78.57±6.14	78.53±6.09	0.030	0.976
躯体限制	术后	92.43±8.52	84.12±7.26	4.8112	0.0000
躯体限制	t值	8.553	3.823	?	?
?	P值	0.000	0.000	?	?
?	术前	77.43±6.52	77.38±6.41	0.035	0.972
社会领域	术后	90.32±7.54	81.26±7.01	5.703	0.000
社会领域	t值	8.380	2.647	?	?
?	P值	0.000	0.010	?	?
?	术前	74.32±5.84	74.39±5.68	0.056	0.956
精神状态	术后	91.43±7.26	83.26±6.57	5.408	0.000
精神状态	t值	11.901	6.619	?	?
?	P值	0.000	0.000	?	?

项目	?	观察组（n=42）	对照组（n=42）	t值	P值
?	术前	75.48±5.28	75.36±5.14	0.106	0.916
生理领域	术后	89.27±7.39	82.15±7.02	4.527	0.000
生理领域	t值	9.840	5.058	?	?
?	P值	0.000	0.000	?	?
?	术前	78.57±6.14	78.53±6.09	0.030	0.976
躯体限制	术后	92.43±8.52	84.12±7.26	4.8112	0.0000
躯体限制	t值	8.553	3.823	?	?
?	P值	0.000	0.000	?	?
?	术前	77.43±6.52	77.38±6.41	0.035	0.972
社会领域	术后	90.32±7.54	81.26±7.01	5.703	0.000
社会领域	t值	8.380	2.647	?	?
?	P值	0.000	0.010	?	?
?	术前	74.32±5.84	74.39±5.68	0.056	0.956
精神状态	术后	91.43±7.26	83.26±6.57	5.408	0.000
精神状态	t值	11.901	6.619	?	?
?	P值	0.000	0.000	?	?

炎性因子	?	观察组（n=42）	对照组（n=42）	t值	P值
?	术前	65.18±5.02	65.32±4.98	0.128	0.898
IL-12p70（pg/mL）	术后	70.21±5.39	80.11±5.02	8.711	0.000
IL-12p70（pg/mL）	t值	4.426	13.555	?	?
?	P值	0.000	0.000	?	?
?	术前	93.76±10.97	93.51±11.24	0.103	0.918
IFN-γ（pg/mL）	术后	109.43±10.51	116.16±10.46	2.941	0.000
IFN-γ（pg/mL）	t值	6.685	9.560	?	?
?	P值	0.000	0.004	?	?
?	术前	842.97±55.12	843.27±54.29	0.025	0.980
TNF-α（pg/mL）	术后	872.32±51.13	897.26±51.34	2.231	0.028
TNF-α（pg/mL）	t值	2.530	2.647	?	?
?	P值	0.013	0.010	?	?

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