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[目的]为提高临床治愈率,了解经翼点入路开颅动脉瘤夹闭术治疗脉络膜前动脉起始部动脉瘤的临床应用价值。[方法]选择2007年1月～2010年12月收住我院神经外科的脉络膜前动脉起始部动脉瘤患者共11例(观察组)。回顾性分析所有患者临床资料,随访其预后转归情况,并与以往其他手术入路比较(对照组)。[结果]所有患者动脉瘤均夹闭成功,术后并发症发生率为9.1%,明显低于对照组(P﹤0.05)。术后随访3～6个月,按GOS量表评定预后情况:预后良好者8例,中度残障者2例,重度残障者1例,明显优于对照组(P﹤0.05)。术后3个月行DSA和MRI复查,动脉瘤均被成功夹闭,无再出血者。[结论]经翼点入路开颅能示使脉络膜前动脉起始部动脉瘤较好暴露于术野,减少夹闭术时对脑组织损伤机会,降低并发症的发生率,取得较好的临床效果。
[Objective] To improve the clinical cure rate, to understand the clinical application value of craniotomy aneurysm clipping via pterional approach for the treatment of aneurysms at the beginning of anterior choroidal artery. [Methods] A total of 11 patients with aneurysm at the beginning of anterior choroidal anastomosis admitted to Department of Neurosurgery from January 2007 to December 2010 were selected (observation group). The clinical data of all patients were retrospectively analyzed. The prognosis was followed up and compared with other surgical approaches (control group). [Results] All the aneurysms were successfully occluded, and the incidence of postoperative complications was 9.1%, which was significantly lower than that of the control group (P <0.05). The patients were followed up for 3 to 6 months. The prognosis was evaluated according to GOS: 8 cases with good prognosis, 2 cases with moderate disability and 1 case with severe disability were significantly better than the control group (P <0.05). DSA and MRI were performed 3 months after operation. All aneurysms were successfully occluded without rebleeding. [Conclusion] Pilocarpus craniotomy can show the aneurysm of the anterior part of anterior choroidal artery exposed to the operative field better, reduce the chance of injury to the brain tissue during occlusion and reduce the incidence of complications, and obtain a better Clinical effect.