急性破裂性颅内动脉瘤血管内治疗的围手术期处理  

Perioperative treatment of the acute ruptured intracranial aneurysms

作　　者：谭显西[1] 钟鸣[1] 吴近森[1] 林晨[1] 张宇[1] 李则群[1] 

机构地区：[1]浙江省温州医学院附属第一医院神经外科,温州325000

出　　处：《中华急诊医学杂志》2003年第3期186-187,共2页Chinese Journal of Emergency Medicine

基　　金：国家十五科技攻关项目资助 (2 0 0 1BA70 3B18)

摘　　要：目的　探讨急性破裂性颅内动脉瘤血管内治疗的围手术期处理。方法　对 72例行血管内治疗的急性破裂性动脉瘤患者的围手术期处理进行回顾性分析。结果　动脉瘤腔闭塞 10 0 %的 3 0个 ,闭塞95 %的 3 6个 ,90 %的 10个 ;1例栓塞术后早期再出血 ,再行开颅动脉瘤夹闭术 ;患者出院时按格拉斯哥预后评分分级 ;Ⅰ级 15例 ,Ⅱ级 4 8例 ,Ⅲ级 4例 ,Ⅴ级 3例。结论　术前主要防止再出血及严重脑血管痉挛 ,术后主要防治继发的神经功能损伤及改善症状 ,正确合理的围手术期处理是降低动脉瘤围手术期严重并发症。Objective To investigate perioperative treatment of the acute ruptured intracranial aneurysms.Methods Perioperative treatments on 72 patients with acute ruptured intracranial aneurysm by endovascular therapy were analyzed retrospectively.Results Seventy six intracranial aneurysms were packed whih coils,and total occlusion was found in 30 cases,more than 95% occlusion in 36 cases,and more than 90% occlusion in 10 cases.According to the Glasgow Scale:48 cases were grade Ⅰ,15 cases grade Ⅱ,4 cases grade Ⅲ,4 cases grade Ⅴ.Conclusion Rebleeding and severe cerebral vascular spasm should be prevented in the preoperation, neurofunctional stepdamnification should be prevented postoperation,and symptom should be ameliorated.Properly perioperative treatment is important to decrease complications and improve the endovascular therapeutic effects.

关 键 词：急性破裂性颅内动脉瘤 血管内治疗 围手术期处理 

分 类 号：R651.1[医药卫生—外科学]