眶上经额纹锁孔手术治疗前循环动脉瘤

摘要

Objective To explore the surgical techniques and indications of microsurgery for anterior circulation aneurysms via supraorbital trans-frontal wrinkle keyhole approach. Methods Clinical data of 73 patients with 79 anterior circulation aneurysms were analyzed retrospectively. All the aneurysms were clipped in microsurgery via supraorbital trans-frontal wrinkle keyhole approach. Results All the aneurysms were clipped successfully. Seventy (95.9%) patients obtained good outcomes and 3 (4.1%) were in physical disability. Head CTA reexamination 1 week after surgery showed that aneurysms disappeared, parent artery kept smoothly and the clip was well fixed. Forty-one patients were followed up for 3 to 6 months and no relapse. Conclusions The treatment for anterior circulation aneurysms via supraorbital trans-frontal wrinkle keyhole approach is a microsurgical technique, which can reduce the injury and complications. The right choice of patients and time and usage of microsurgery techniques are the key points.%目的：探讨眶上经额纹锁孔神经外科手术治疗前循环动脉瘤的手术技巧和适应证。方法回顾性分析73例共79个前循环动脉瘤病人的临床资料，采用眶上经额纹锁孔开颅，行显微神经外科手术动脉瘤夹闭。结果73例全部夹闭，恢复良好70例（95.9%），病残3例（4.1%）。术后1周头部CTA复查：动脉瘤消失，载瘤动脉通畅，动脉瘤夹固定良好。41例于术后3~6个月进行随访，未见复发。结论眶上经额纹锁孔手术是治疗前循环动脉瘤的微创治疗技术，减少手术创伤及并发症，恰当的选择适应证和手术时机以及应用显微外科技术是关键。