超早期血管内栓塞联合脑室外引流治疗Hunt-HessⅣ~Ⅴ级前交通动脉瘤破裂合并脑室出血的疗效分析  

Efficacy of ultra-early endovascular embolization combined with extra-ventricular drainage in the treatment of ruptured Hunt-Hess grade Ⅳ-Ⅴ anterior communicating aneurysm with ventricular hemorrhage

作　　者：马修尧[1] 刘彬 任超[1] 胡萍 范鹏坤 薛振生 MA Xiuyao;LIU Bin;REN Chao;HU Ping;FAN Pengkun;XUE Zhensheng(Cerebrovascular Disease Centre,Suzhou First People's Hospital,Suzhou 234000,China;不详)

机构地区：[1]宿州市第一人民医院脑血管病诊疗中心,234000

出　　处：《浙江医学》2022年第20期2204-2207,2212,共5页Zhejiang Medical Journal

摘　　要：目的探讨超早期血管内栓塞联合脑室外引流治疗Hunt-HessⅣ~Ⅴ级前交通动脉瘤破裂合并脑室出血的疗效。方法选择2019年1月至2020年1月宿州市第一人民医院收治的Hunt-HessⅣ~Ⅴ级前交通动脉瘤破裂合并脑室出血患者16例,均予超早期(发病24 h内)血管内栓塞联合脑室外引流治疗。术后评估栓塞结果,并行6个月随访。采用格拉斯哥预后分级量表(GOS)评分评价随访结果。结果16例患者Ⅰ度12例,Ⅱ度4例。术中出现大脑前动脉痉挛4例。术后1个月因脑积水行脑室-腹腔分流术3例。16例患者均获得6个月随访。其中,GOS评分5分10例,4分4例,2分2例。结论超早期血管内栓塞联合脑室外引流是治疗Hunt-HessⅣ~Ⅴ级前交通动脉瘤破裂合并脑室出血有效方法。Objective To investigate the efficacy of ultra-early endovascular embolization combined with external ventricular drainage in the treatment of ruptured Hunt-Hess gradeⅣ-Ⅴanterior communicating aneurysm with ventricular hemorrhage.Methods From January 2019 to January 2020,16 patients with ruptured Hunt-Hess gradeⅣ-Ⅴanterior communicating aneurysm with intraventricular hemorrhage were treated by ultra-early endovascular embolization within 24 h combined with external ventricular drainage in Suzhou First People's Hospital.The patients were followed up for 6 months and Glasgow outcome scale(GOS)was used to evaluation.Results There were 12 cases of gradeⅠand 4 cases of gradeⅡ.Anterior cerebral artery spasm occurred in 4 patients.Three patients underwent ventriculoperitoneal shunt due to hydrocephalus 1 month after operation.The GOS score was 5 in 10 cases,4 in 4 cases,and 2 in 2 cases.Conclusion Ultra-early endovascular embolization combined with external ventricular drainage is an effective method for the treatment of ruptured Hunt-Hess gradeⅣ-Ⅴanterior communicating aneurysm complicated with ventricular hemorrhage.

关 键 词：介入治疗 动脉瘤 HUNT-HESS分级 脑室出血 

分 类 号：R651.12[医药卫生—外科学]