早期颅动脉瘤夹闭术对前循环动脉瘤破裂出血危重患者预后的影响  

Effect of early cranial aneurysm clipping on the prognosis of severe patients with anterior circulation aneurysm rupture hemorrhage

作　　者：余任喜 李佳[1] 陈坤山[1] 沈峰[1] 祝斐[1] Yu Renxi;Li Jia;Chen Kunshan(The Lushan Rehabilitation and Rehabilitation Center of Chinese People's Liberation Army,Jiujiang,Jiangxi332000)

机构地区：[1]中国人民解放军联勤保障部队庐山康复疗养中心,江西九江332000

出　　处：《基层医学论坛》2020年第22期3124-3125,共2页The Medical Forum

摘　　要：目的探讨早期行颅动脉瘤夹闭术治疗前循环动脉瘤破裂出血危重患者的疗效。方法选择2016年2月—2019年2月我院收治的80例前循环动脉瘤破裂出血危重患者作为研究对象,所有患者均在发病24 h内行颅动脉瘤夹闭术,观察手术、并发症及预后情况。结果所有患者均顺利完成手术,手术时间(223.65±13.23)min,术中出血量(332.33±20.63)mL,住院时间(31.32±8.43)d。术后患者出现交通性脑积水7例、脑梗死10例、症状性脑血管痉挛7例,肺部感染6例,并发症发生率为37.50%(30/80);术后随访9个月,格拉斯哥预后(GOS)分级:Ⅰ级12例、Ⅱ级16例、Ⅲ级34例、Ⅳ级5例,Ⅴ级13例。结论前循环动脉瘤破裂出血危重患者在早期行颅动脉瘤夹闭术具有较好的疗效,可在一定程度上改善预后。Objective To investigate the efficacy of early intracranial aneurysm clipping in treatment of severe patients with anterior circulation aneurysm rupture hemorrhage.Methods 80 severe patients with anterior circulation aneurysm rupture hemorrhage who admitted in the hospital from February 2016 to February 2019 were selected as research subjects.All patients underwent early intracranial aneurysm clipping within 24h of onset.The surgery,complications and prognosis were observed.Results All patients underwent surgery successfully,the operation time,intraoperative bleeding volume and hospital stays were(223.65±13.23)min,(332.33±20.63)mL,(31.32±8.43)d,respectively.After surgery,there were 7 cases of communicating hydrocephalus,10 cases of cerebral infarction,7 cases of symptomatic cerebral vasospasm,6 cases of pulmonary infection,and the incidence of complications was 37.50%(30/80);After surgery for 9 months of follow-up,the Glasgow Outcome Scale(GOS)grading:12 cases of gradeⅠ,16 cases of gradeⅡ,34 cases of gradeⅢ,5 cases of gradeⅣ,13 cases of gradeⅤ.Conclusion Early intracranial aneurysm clipping in treatment of severe patients with anterior circulation aneurysm rupture hemorrhage has certain efficacy,it can improve the prognosis of patients.

关 键 词：前循环动脉瘤破裂出血 危重患者 早期 颅动脉瘤夹闭术 预后 

分 类 号：R651.1[医药卫生—外科学]