眶上外侧入路治疗急性期不同瘤顶指向的破裂前交通动脉动脉瘤的疗效

发布时间：2018-06-24 17:01

本文选题：动脉瘤 + 前交通动脉　；参考：《中国脑血管病杂志》2017年09期

【摘要】：目的探讨眶上外侧入路开颅手术治疗急性期不同瘤顶指向的破裂前交通动脉动脉瘤(ACoAA)的疗效。方法回顾性分析苏州大学附属第一医院2014年1月至2017年3月经眶上外侧入路开颅显微手术治疗的79例急性期不同瘤顶指向的破裂ACoAA患者的临床资料,采用格拉斯哥预后评分(GOS)评价术后3~36个月的预后情况。结果 79例患者中,瘤顶指向上型34例,下型37例,复杂型8例。ACoAA均被夹闭成功。术后随访3~36个月,GOS示预后良好者70例(88.6%),其中上型26例,下型36例,复杂型8例;轻度残疾者9例(11.4%),其中上型8例,下型1例;无一例重度残疾、植物生存及死亡;动脉瘤瘤顶指向下型者预后较指向上型者好[97.3%(36/37)比76.5%(26/34)],差异有统计学意义(χ2=5.19,P0.05)。结论眶上外侧入路是治疗急性期不同瘤顶指向的破裂ACoAA的有效手段,瘤顶指向下型者疗效优于上型者。
[Abstract]:Objective to evaluate the efficacy of supraorbital approach in the treatment of ruptured anterior communicating artery aneurysms (ACoAA) with different apex points in acute stage. Methods from January 2014 to March 2017, 79 patients with ruptured ACoAA with different apical points were retrospectively analyzed in the first affiliated Hospital of Suzhou University. Glasgow prognostic score (GOS) was used to evaluate the prognosis 3 ~ 36 months after operation. Results among 79 patients, 34 cases had superior type, 37 cases had inferior type, 8 cases had complicated type. ACoAA was clipped successfully. After 3 ~ 36 months follow-up, 70 cases (88.6%) showed good prognosis, including 26 cases of upper type, 36 cases of inferior type, 8 cases of complex type, 9 cases (11.4%) of mild disability, including 8 cases of upper type and 1 case of inferior type, no severe disability, vegetative survival and death. The prognosis of the patients with the subtype at the top of the aneurysm was better than that with the superior type [97.3% (36 / 37) vs 76.5% (26 / 34)], and the difference was statistically significant (蠂 2 / 5.19 P 0.05). Conclusion supraorbital approach is an effective method for the treatment of ruptured ACoAA with different apical points in acute stage.
【作者单位】：苏州大学附属第一医院神经外科;
【基金】：国家自然科学基金(81501005)
【分类号】：R651.12

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