影响颅内动脉瘤夹闭术后脑血管痉挛的相关因素分析  

Related Analysis on the Factors to Cerebral Vasospasm after Clipping of Intracranial Aneurysm

作　　者：张海涛[1] 耿守科 王永和[3] 曹培成[3] 卜振富[3] 李爱军[3] 程迎新[3] 

机构地区：[1]潍坊医学院外科学教研室,山东潍坊261053 [2]平度市第三人民医院外科 [3]潍坊医学院附属潍坊市人民医院脑科医院神经外科

出　　处：《潍坊医学院学报》2012年第3期177-179,共3页Acta Academiae Medicinae Weifang

摘　　要：目的探讨颅内动脉瘤夹闭术后脑血管痉挛（CVS）发生的相关因素。方法对45例颅内动脉瘤患者采用经颅多普勒诊断为CVS。结合术前蛛网膜下腔出血（SAH）改良的Fisher分级、手术时机、术中动脉孺有无破裂、术中用药、术后蛛网膜下腔积血等资料进行相关分析。结果术前改良的Fisher分级与CVS的发生明显相关；SAH后3d内手术CVS的发生率明显低于3d后手术。术中动脉瘤破裂CVS的发生率明显高于未破裂者；术中用药CVS的发生率明显少于未用药者。术后蛛网膜下腔积血与CVS发生显著相关。结论动脉瘤夹闭术后CVS可能是SAH后CVS病理过程的延续，早期手术，完善术中、术后处理，可降低术后CVS的发生率。Objective To explore the related factors to cerehral vasospasm after clipping of intracranial an- eurysm. Methods Forty-five cases with intracranial aneurysm were diagnoses vasospasm by transcranial Dopple（ TCD ）. Clinical materials including improved Fisher Scale of the subarachnoid hemorrhage （SAH） , opportunities of operation, an- eurysm rupture in operation, medication in operation, subarachnoid hematocele after operation were analysed. Results Preoperative improved Fisher Scale was related to the incidence of vasospasm, the vasospasm incidence of operation in three days after SAH group was significantly lower than later group of the three （lays. The vasospasm incidence of aneu- rysm rupture in operation was significantly higher than aneurysm unrupture, the vasospasm incidence of medication in op- eration was less than no medication in operation, postoperative subarachnoid hematocele was related to the incidence of vasospasm. Conclusion Postoperative cerebral vasospasm may be the prolonged pathology process of vasospasm after SAH, Early period operation,improve intraoperative and postoperative management,and it can decrease the incidence of postoperative vasospasm.

关 键 词：颅内动脉瘤 夹闭术 蛛网膜下腔出血 脑血管痉挛 

分 类 号：R739.41[医药卫生—肿瘤]