本文選題：動脈瘤 + 前交通動脈��； 參考：《中國腦血管病雜志》2017年09期

【摘要】：目的探討眶上外側(cè)入路開顱手術(shù)治療急性期不同瘤頂指向的破裂前交通動脈動脈瘤(ACoAA)的療效。方法回顧性分析蘇州大學附屬第一醫(yī)院2014年1月至2017年3月經(jīng)眶上外側(cè)入路開顱顯微手術(shù)治療的79例急性期不同瘤頂指向的破裂ACoAA患者的臨床資料,采用格拉斯哥預(yù)后評分(GOS)評價術(shù)后3~36個月的預(yù)后情況。結(jié)果 79例患者中,瘤頂指向上型34例,下型37例,復雜型8例。ACoAA均被夾閉成功。術(shù)后隨訪3~36個月,GOS示預(yù)后良好者70例(88.6%),其中上型26例,下型36例,復雜型8例;輕度殘疾者9例(11.4%),其中上型8例,下型1例;無一例重度殘疾、植物生存及死亡;動脈瘤瘤頂指向下型者預(yù)后較指向上型者好[97.3%(36/37)比76.5%(26/34)],差異有統(tǒng)計學意義(χ2=5.19,P0.05)。結(jié)論眶上外側(cè)入路是治療急性期不同瘤頂指向的破裂ACoAA的有效手段,瘤頂指向下型者療效優(yōu)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.
【作者單位】： 蘇州大學附屬第一醫(yī)院神經(jīng)外科;
【基金】：國家自然科學基金(81501005)
【分類號】：R651.12

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