神经介入联合显微神经外科手术治疗后循环动脉瘤破裂出血伴脑疝形成  

Neurointervention combined with microneurosurgery for patients with ruptured posterior circulation aneurysms and herniation

作　　者：刘建峰[1] 李辉[1] 张峰[1] 侯凯[1] 高金玲[1] 李鹏[1] 井山泉[1] 张超[1] 

机构地区：[1]河北医科大学第一医院神经外科,石家庄,050031

出　　处：《中华神经医学杂志》2014年第9期939-943,共5页Chinese Journal of Neuromedicine

基　　金：河北省卫生厅青年科技课题（20130585）

摘　　要：目的 探讨神经介入联合显微神经外科手术治疗后循环动脉瘤破裂出血伴脑疝形成的临床疗效. 方法 河北医科大学第一医院神经外科自2010年1月至2013年8月急诊综合治疗（早期侧脑室引流术、神经介入动脉瘤栓塞术及后颅窝减压术）11例后循环动脉瘤破裂出血伴脑疝形成患者,其中小脑后下动脉动脉瘤5例、大脑后动脉动脉瘤2例、基底动脉顶端动脉瘤3例、椎基底动脉移行处动脉瘤1例,采用改良Rankin分级量表（mRS）评分和Glasgow预后分级量表（GOS）评分评价患者的预后. 结果 术后13d1例因并发肺部感染和应激性溃疡死亡,剩余患者出院后6个月随访显示5例恢复良好,3例植物生存,2例重残. 结论 神经介入联合显微神经外科手术可以降低后循环动脉瘤破裂伴脑疝形成的死亡率及致残率.Objective To investigate the therapeutic effects of endovascular interventional therapies combined with microneurosurgery on patients suffered from cerebral herniation induced by raptured posterior circulation aneurysms.Methods Eleven patients with cerebral hemiation induced by ruptured posterior circulation aneurysms,admitted to our hospital from January 2010 to August 2013,were chosen in our study; among them,five had aneurysms of posterior inferior cerebellar artery,two aneurysms of posterior cerebral artery,three aneurysms of basilar artery apexand and one aneurysm of vertebrobasila transitional.The prognosis was assessed by modified Rankin scale （mRS） and Glasgow outcome scale （GOS）.Results During the period of hospitalization,1 patient dead of pulmonary infection and stress ulcer; six months of follow up showed that five patients got good improvement,three patients were living on the vegetative state and two patients were in severe disability.Conclusion The endovascular interventional treatment combined with microneurosurgery can reduce the mortality and disability of patients with cerebral hemiation induced by ruptured posterior circulation aneurysms.

关 键 词：神经介入 显微神经外科 后循环动脉瘤 脑疝 

分 类 号：R651.12[医药卫生—外科学]