经眉弓锁孔入路夹闭前循环破裂动脉瘤

摘要

目的 探讨经眉弓锁孔入路手术夹闭大脑前循环破裂动脉瘤的技术及经验.方法 回顾性分析我科经眉弓锁孔入路治疗前循环破裂动脉瘤的临床资料,领悟手术理念,总结手术时机、手术方法、操作技巧等方面的经验教训.结果 56例(59个)动脉瘤全部一次手术夹闭成功,均未出现手术入路相关并发症,其中4例术中有动脉瘤破裂出血,2例合并有脑积水并行脑室腹腔分流术,1例死于肺部感染及多脏器功能衰竭,52例患者出院6个月后复查 DSA显示夹闭良好.结论 眉弓锁孔入路显微外科手术是治疗前循环破裂动脉瘤的一种有效、安全的微创方法.%Objective To explore the technique and experience of supraorbital keyhole approach in surgical clipping of anterior cerebral circulation ruptured aneurysm.Methods We retrospectively analyzed the clinical data of the treatment of rup-tured anterior circulation aneurysms through the supraorbital keyhole approach in our department,learned the operation concept, summed up the experience of the operation time,operation method,operation skill and so on.Results 56 cases(59) aneurysms were successfully closed by one operation,and no operative complications were found.Among them,there were 4 cases of ruptured aneurysm bleeding,2 cases complicated with concurrent hydrocephalus ventriculoperitoneal shunt,1 case died of pulmonary infec-tion and multiple organ failure,52 patients discharged after 6 months showed good DSA clipping.Conclusion Microsurgery with supraorbital keyhole approach is an effective and safeminimally invasive method for the treatment of ruptured anterior circulation aneurysms.