动脉瘤性蛛网膜下腔出血致Terson综合征行玻璃体切割术治疗的临床分析  

Vitrectomy for treatment of terson syndrome in patients with aneurymal subarachnoid hemorrhage

作　　者：狄广福[1] 方兴根[1] 李真保[1] 徐善水[1] 徐进[2] 金绘祥[3] 陈三送[1] 杨士勇[1] 

机构地区：[1]皖南医学院第一附属医院弋矶山医院神经外科,芜湖241001 [2]皖南医学院第一附属医院弋矶山医院超声医学科,芜湖241001 [3]皖南医学院第一附属医院弋矶山医院眼科,芜湖241001

出　　处：《临床神经外科杂志》2014年第4期272-274,278,共4页Journal of Clinical Neurosurgery

基　　金：皖南医学院第一附属医院弋矶山医院人才引进基金(YR 201105)

摘　　要：目的：探讨动脉瘤性蛛网膜下腔出血（ aSAH ）所致Terson综合症的临床治疗效果。方法对我院确诊13例颅内破裂动脉瘤致Terson综合症的患者，13例（21只眼）均行玻璃体切割术的疗效进行回顾性分析。结果13例病例中，前交通动脉瘤4例，后交通动脉瘤3例，小脑后下动脉瘤3例，基底动脉顶端动脉瘤1例，椎-基底动脉夹层动脉瘤1例，椎动脉-小脑后下动脉夹层动脉瘤1例。21眼行玻璃体切割术，术后随访3～12个月，平均随访6．1月，21只眼视力均有所提高，平均视力恢复至0．45，其中视力≥0．3者16眼，占76．2％。结论对aSAH患者应常规进行眼科筛查有无Terson综合症；玻璃体切割术是治疗Terson综合症安全有效的，可以提高患者的生活质量。Objective To investigate the clinical effects of Terson syndrome in patients with aneurysmal subarachnoid hemorrhage （aSAH）.Methods The clinical data of 13 patients with aSAH diagnosed terson syndrome and 21 eyes were underwent vitrectomy , were analyzed retrospectively . Results Of the 13 cases, 4 were anterior communicating aneurysms （ ACoA ）, 3 posterior communicating artery aneurysms （PCoA）,3 posterior inferior cerebellar artery aneurysms （PICAA）,1 basilar artery apex aneurysms （ BAAA ） , 1 vertebrobasilar dissecting aneurysms （ VB-DA ） and 1 aneurysms of the vertebral artery-posterior inferior cerehellar artery （ VA-PICA ） .21 eyes underwent vitrectomy.Patients were followed up from 3 to 12（average 6.1）months.The visual acuity improved in all cases.The average visual acuity was 0.45 after operation .16 eyes （ 76.2%） achieved a postoperative visual acuity of ≥0.3.Conclusions Terson syndrome is likely to occur in aSAH , therefore ,patients with the diagnosis of aSAH should be submitted to a funduscopic examination . Vitrectomy is an effective method to treat terson syndrome , which can improve the life quality of the patients.

关 键 词：动脉瘤性蛛网膜下腔出血 Terson综合症 玻璃体切割术 

分 类 号：R743.35[医药卫生—神经病学与精神病学]