破裂脑动脉瘤的早期手术治疗  

Early operation for the treatment of ruptured cerebral aneurysms

作　　者：周岱[1] 陈宗孚 张世明[1] 王中[1] 陈忠平[1] 朱风清[1] 何乃吉[1] 杨学照[1] 惠国桢[1] 鲍耀东[1] 杜子威[1] 高明[1] 张立勇[1] 

机构地区：[1]苏州医学院附院,张家港市第一人民医院,建湖县人民医院

出　　处：《中华神经外科杂志》1994年第1期10-12,共3页Chinese Journal of Neurosurgery

基　　金：江苏省科委资助

摘　　要：早期手术治疗４５例破裂脑动脉瘤，其中颈内动脉瘤１５例，前交通动脉瘤１８例，大脑前动脉瘤１例，大脑中动脉瘤１１例。破裂后３天内手术者３１例，其余在４～６天手术。术后死亡６例。Ｗｉｌｌｉｓ环前半部破裂的脑动脉瘤，如无明显血管痉挛，可在６天内行早期手术治疗。除了夹闭瘤蒂、杜绝再出血的危险外，下列措施：术中清除脑池内凝血块、应用罂粟碱溶液冲洗脑池、静脉投用胰岛素及去骨瓣减压等对于防止脑血管痉挛及脑梗塞有一定的作用。Abstract patients with ruptured aneurysms were treated in early stage.There are 15 aneurysms located internalcarotid artery,18 in anterior communicating artery,1 in anterior cerebral artery and 11 in middle cerebral artery.31 cases were operated within three days after rupture,while others received operation from four to six days'duration.Postoperatively,six patients died.Early operation within six days of the ruptured cerebral aneurysms of the anterior circulation is recommended if there was no obvious vasospasm.Treatment including clipping the aneurysms,cleaning up the clots in the basal cistern,irrigating the cistern with papaverine hydrochloride,intravenous administrating with Glucose-Insulin-Potassium solution,mannitol and dexamethasone,as well as decompressing with cranioectomy,are effective for the prevention of vasospasm and brain infarct with ruptured intracranial aneurysms.

关 键 词：动脉瘤 血管痉挛 显微外科手术 

分 类 号：R739.41[医药卫生—肿瘤]