| Objective:To compare the efficacy and safety between supraorbital lateral approach and pterional approach for microsurgical clipping of the ruptured anterior communicating aneurysms by analyzing the clinical data.Method:The clinical data of 118 patients with ruptured anterior communicating aneurysms from November 2014 to May 2017 were included and divided two groups according to the operation mode.Among them,61cases were treated by supraorbital lateral approach and 57 cases were treated by pterional approach,preoperative baseline data,intraoperative status,postoperative complications and GOS scores at discharge were compared between the two groups.Results:CTA examination within 1 week after operation in both groups confirmed that aneurysms were completely occluded.The length of the surgical incision(11.2±1.1)cm,the size of bone flap(2.8±0.2)cm2,the operation time(184±38)min and the surgical bleeding volume(170±147)ml were lower than those of the pterional approach's length of the surgical incision(16.4±2.1)cm,size of bone flap(5.1±0.4)cm2,operation time(285±50)min and surgical bleeding volume(221±101)ml;The rate of intracranial infection in supraorbital lateral approach was 9.80%and the rate of poor scalp healing was 0 in 61 cases were lower than those in pterional approach;There was statistical significance(P<0.05).(6.50%)had ruptured aneurysm in supraorbital lateral approach,(4.90%)had postoperative chronic hydrocephalus and(91.80%)had good prognosis at discharge,there was no significant difference in pterional approach's aneurysm rupture rate(3.50%),postoperative chronic hydrocephalus incidence(5.20%)and good prognosis at discharge(85.90%),with no statistical significance(P>0.05).Conclusion:The supraorbital lateral approach and pterional approach can safely and effectively occlude the ruptured anterior communicating aneurysms.However,the supraorbital lateral approach has the advantages of high efficiency,less trauma and less postoperative complications. |
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