高分级动脉瘤性蛛网膜下腔出血合并呼吸抑制患者的手术治疗  

Surgical treatment for patients of poor grade aneurysmal subarachnoid hemorrhage and respiratory depression

作　　者：周新民[1] 韩进[1] 冯东侠[1] 叶富华[1] 高恒[1] 

机构地区：[1]东南大学医学院附属江阴医院神经外科,江苏省江阴市214400

出　　处：《中华神经外科杂志》2011年第12期1212-1215,共4页Chinese Journal of Neurosurgery

摘　　要：目的 评价高分级动脉瘤性蛛网膜下腔出血合并呼吸抑制患者显微手术治疗的疗效.方法 同顾性分析7例动脉瘤性蛛网膜下腔出血合并呼吸抑制患者的资料,患者均在进行呼吸功能复苏抢救后急行显微外科手术治疗,以GOS评分量表对患者神经功能评分.结果 7例患者的7个动脉瘤均显微手术夹闭,术后6个月时的GOS评分：恢复良好2例,中度病残但生活自理3例,重度病残、生活不能自理1例,死亡1例.结论 对即使已经合并呼吸抑制的高分级动脉瘤患者急性期手术治疗是可行的,结合及时的气管插管控制呼吸,脑室外引流以及去骨板减压等处理可以帮助改善其预后.Objective To evaluate the clinical strategy and effects of microsurgery for patients of poor grade aneurysmal subarachnoid hemorrhage and respiratory depression.Methods The data of 7 patients from April 2003 to November 2009 were retrospectively analyzed.Urgent microsurgery after pulmonary resuscitation were performed in all patients.Glasgow Outcome Scale （GOS） was used for postoperative evaluation of neurological function.Results 7 aneurysms of 7 patients were all clipped.The follow - up results （6 months after surgery） revealed good outcome in 2 cases,mild disability in 3,severe disability in 1and 1 death.Conclusions It is feasible to perform surgical treatment for poor grade aneurysm patients in acute stage even though the patient is complicated with respitatory depression.Tracheal intubation promptly,external ventricular drainage and decompressive craniectomy could help to improve the outcome of patient.

关 键 词：蛛网膜下腔出血 动脉瘤 显微外科手术 呼吸抑制 高级别 

分 类 号：R651.1[医药卫生—外科学]