CAJ | 학술논문

目的：探讨应用眶上外侧入路显微外科手术夹闭前循环破裂动脉瘤的临床疗效和手术技巧。方法收集我科20例应用眶上外侧入路行前循环破裂动脉瘤夹闭术患者的临床资料进行分析。术前按照Hunt-Hess分级Ⅰ～Ⅲ级以及改良CT Fisher分级Ⅱ～Ⅲ级作为入选标准，术后以格拉斯哥结果评分（ GOS）评价手术效果。结果20个动脉瘤均一次夹闭成功。根据GOS评估标准，恢复良好者18例，轻残2例。所有病例无术后感染、面神经损伤、出血及脑脊液漏等手术并发症。结论眶上外侧入路是一种安全而有效的微创手术入路，适宜在低分级的前循环破裂动脉瘤夹闭术中应用。
목적：탐토응용광상외측입로현미외과수술협폐전순배파렬동맥류적림상료효화수술기교。방법수집아과20례응용광상외측입로행전순배파렬동맥류협폐술환자적림상자료진행분석。술전안조Hunt-Hess분급Ⅰ～Ⅲ급이급개량CT Fisher분급Ⅱ～Ⅲ급작위입선표준，술후이격랍사가결과평분（ GOS）평개수술효과。결과20개동맥류균일차협폐성공。근거GOS평고표준，회복량호자18례，경잔2례。소유병례무술후감염、면신경손상、출혈급뇌척액루등수술병발증。결론광상외측입로시일충안전이유효적미창수술입로，괄의재저분급적전순배파렬동맥류협폐술중응용。
Objective To study therapeutic effect of microsurgery via lateral supraorbital ( LSO ) approach on ruptured aneurysms of anterior circulation and its techniques .Methods The clinical data of 20 patients with low grade ruptured aneurysms of anterior circulation who treated with microsurgery via LSO approach in our department were analyzed retrospectively .All patients were at Hunt-HessⅠ-Ⅲand Improved Fisher's ScaleⅡ~Ⅲbefore anatomy .The neurological functions were scored according to GOS.Results Total 20 aneurysms were clipped successfully in one operation via LSO approach . Outcome was considered according to GOS as good recovery in 18 patients and mild disability in 2. There was no temporal muscle atrophy ,bleeding,CSF leakage and injury of the upper branch of the facial never after operations .Conclusion Microsurgery via LSO approach is a safe , minimally invasive and effective way for the treatment of low grade ruptured aneurysms of anterior circulation .