血肿型前循环破裂动脉瘤的急诊显微手术效果评价  

Effect evaluation of emergency microsurgery in treatment of patients with hematoma-type anterior circulation ruptured aneurysm

作　　者：吴臣义[1] 孙彦军 邹飞辉 刘芳[1] 杨劲松[1] 王明海[1] 刘科峰[1] 王有刚[1] WU Chenyi;SUN Yanjun;ZOU Feihui;LIU Fang;YANG Jinsong;WANG Minghai;LIU Kefeng;WANG Yougang(Department of Neurosurgery,Changzhou Second People's Hospital Affiliated to Nanjing Medical University,Changzhou,Jiangsu,213004)

机构地区：[1]南京医科大学附属常州市第二人民医院神经外科,江苏常州213004

出　　处：《实用临床医药杂志》2018年第3期16-18,22,共4页Journal of Clinical Medicine in Practice

摘　　要：目的评价血肿型前循环破裂动脉瘤行急诊显微手术治疗的疗效。方法回顾性分析急诊显微手术治疗的32例前循环破裂动脉瘤伴脑内血肿患者的临床资料和治疗效果。结果 32例患者均在24 h内行急诊开颅动脉瘤夹闭并血肿清除术,其中15例行去骨瓣减压术。术后1周复查CTA均完全夹闭动脉瘤,1例术后出现交通性脑积水行脑室-腹腔分流手术,6例出现不同程度的脑梗死。术后随访6个月,GOS预后分级5级5例(15.6%),4级12例(37.5%),3级12例(37.5%),2级2例(6.3%),1级1例(3.1%)。预后满意率为53.1%。结论急诊显微手术治疗血肿型前循环破裂动脉瘤疗效满意。Objective To evaluate the effect of emergent microsurgery in treatment of patients with hematoma-type anterior circulation ruptured aneurysm.Methods The clinical data and therapeutic effect of emergency microsurgery for 32 patients with hematoma-type anterior circulation ruptured aneurysm were analyzed retrospectively.Results Finally 32 patients underwent emergency craniotomy clipping and hematoma removal in 24 h.Among them,15 cases underwent decompressive craniectomy.One week after the operation,CTA revealed that all aneurysms were completely clipped.One patient with communicating hydrocephalus were treated with ventriculoperitoneal shunt,and 6 patients had different degrees of cerebral infarction.After 6 months of follow-up,the Glasgow outcome scale(GOS)showed that there were 5 cases of grade 5(15.6%),12 cases of grade 4(37.5%),12 cases of grade 3(37.5%),2 cases of grade 2(6.3%)and 1 case of grade 1(6.3%).The prognosis satisfaction rate was 53.1%(17/32).Conclusion Emergent microsurgery is effective in the treatment of patients with hematoma-type anterior circulation ruptured aneurysm.

关 键 词：前循环动脉瘤 颅内血肿 显微外科手术 颅动脉瘤 

分 类 号：R543.1[医药卫生—心血管疾病]