颅内动脉瘤破裂出血并脑疝形成的急诊手术探查  

Emergent surgery for ruptured intracranial aneurysms accompanied by cerebral hernias

作　　者：宋朝理[1] 庄进学[1] 陈登奎[1] 郑小强[1] 程宏炜[1] 薛峰[1] 李海龙[1] 陶传元[1] 张炜[1] 魏攀[1] 

机构地区：[1]中国人民解放军第452医院神经外科,四川成都610000

出　　处：《中国临床神经外科杂志》2011年第9期536-537,544,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨颅内动脉瘤破裂出血并脑疝患者急诊手术的可行性。方法 5例颅内动脉瘤破裂出血并脑疝形成患者入院经CT检查后直接急诊开颅探查,术中先清除部分颅内血肿,降低颅内压,后行动脉瘤探查并夹闭;对探查过程中再次破裂出血者及时控制出血并夹闭动脉瘤。术后3月按GOS分级标准对患者的预后进行评价。结果术中发现前交通动脉瘤2例,后交通动脉瘤2例,大脑中动脉瘤1例。按GOS评价预后,恢复良好2例,中残1例,植物生存1例,死亡1例。结论动脉瘤破裂出血并脑疝者病情危重,需要急诊手术;只要术前准备充分,即使在探查中动脉瘤再次出血,也能很好地控制出血并夹闭动脉瘤。Objective To explore the practicability of the emergent surgery for ruptured intracranial aneurysms accompanied by cerebral hernias.Methods The intracerebral hematomas were removed and then intracranial aneurysms were clipped by emergent surgery in 5 patients with ruptured intracranial aneurysms accompanied by cerebral hernias.The prognosis was assessed by GOS 3 months after the surgery in all the patients.Result Of 5 patients,2 were recovered well,1 moderately disabled,1 survived vegetatively and 1 died according to GOS 3 months after the surgery.Conclusion The emergent surgery should be performed in the patients with ruptured intracranial aneurysms accompanied by cerebral hernias.

关 键 词：颅内动脉瘤 脑疝 急诊手术 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R651.12[医药卫生—临床医学]