Hunt-Hess Ⅳ～Ⅴ级动脉瘤手术治疗体会  

Surgical treatment of Hunt-Hess grade Ⅳ-Ⅴintracranial aneurysms

作　　者：李太平[1] 娄平阳[1] 

机构地区：[1]河南省人民医院神经外科,郑州450003

出　　处：《中国实用神经疾病杂志》2015年第3期27-29,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨Hunt-HessⅣ-Ⅴ级动脉瘤的手术治疗方法和时机。方法回顾性分析我科2006-01—2013-06收治的117例Hunt-HessⅣ-Ⅴ级动脉瘤,其中Ⅳ级96例,Ⅴ级21例。本组病例均在蛛网膜下腔出血24-48h内手术治疗,动脉瘤夹闭103例,夹闭加包裹14例,去骨瓣减压19例,侧脑室开放引流13例。结果按GOS标准评分,Ⅳ级96例中5分23例,4分28例,3分33例,2分和1分12例。Ⅴ级21例中4分1例,3分5例,2分和1分15例。结论对于Hunt-HessⅣ级患者要在蛛网膜下腔出血早期（1-2d）手术干预,Ⅴ级伴较大血肿或脑室大量积血积水患者建议早期手术,同时去骨瓣减压或脑室引流。Objective To explore the method and timing for Hunt-Hess grade Ⅳ-Ⅴ intracranial aneurysms.MethodsThe clinical data of 117 cases Hunt-Hess gradeⅣ-Ⅴ aneurysms admitted to our department from January 2006 to June 2013 were analyzed retrospectively,among which 96 cases Hunt-Hess gradeⅣ,21 cases gradeⅤ.All of them were surgically treated within 24-48 hours after aneurysm ruptured of which 103 cases clipped and 14 cases clipped plus wrapped.Results The prognosis was assessed by Glasgow outcome scale（GOS）,96 cases gradeⅣachieved 5score 23 cases,4score 28 cases,3score33cases,2and1 score 12cases.21 cases gradeⅤ achieved 4score 1case,3score 5cases,2and1 score 15cases.Conclusion It is better for Hunt-Hess gradeⅣ patients be treated surgically within 1-2days after aneurysms ruptured.Surgical treatment is not recommended for Hunt-Hess gradeⅤ patients unless there is giant haematoma or acute hydrocephalus.

关 键 词：颅内动脉瘤 显微手术 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]