摘要
目的探讨老年颅内破裂动脉瘤患者施行开颅夹闭手术的治疗效果。方法根据CT及CTA图像经翼点入路，选择适当的位置和角度对75例顷内动脉瘤破裂患者动脉瘤进行夹闭，观察手术疗效及术后并发症，采用格拉斯哥预后量表（GOS）对预后情况进行评定。结果75例患者中共有动脉瘤77个，夹闭76个；术后并发症主要为颅内血肿5例，肺部感染4例，电解质紊乱10例，颅内感染2例，心律失常3例，消化道出血5例，脑梗死3例；根据GOS对预后进行评估，治愈者48例（64．0％），轻度残障者16例（21．3％），重度残障者6例（8．0％），植物生存者2例（2．7％），死亡3例（4．0％），治愈率64．0％，总体预后良好率为85．3％。结论使用开颅夹闭的方法对高龄颅内破裂动脉瘤进行治疗，手术疗效好，治愈率高。
Objective To explore the efficacy of craniotomy and aneurysm clipping in elderly patients with ruptured intracranial aneurysms. Methods Totally 75 elderly patients with ruptured intracranial aneurysms in our hospital who underwent craniotomy and intracranial aneurysm clipping： approaching into head by wing point based on CT image, selecting the appropriate position and angle for clipping the aneurysm. Surgical efficacy and postoperative complications were observed. Prognosis was assessed by Glasgow Outcome Scale （GOS）. Results 77 aneurysms presented in 75 patients and 76 aneurysms were clipped. The main postoperative complications were intracranial hematoma （5 cases）, pulmonary infection （4 cases）, electrolyte imbalance （10 cases）, intracranial infection （2 cases）, arrhythmia （3 cases）, gastrointestinal bleeding （5 cases）, cerebral infarction （3 cases）. GOS assessment demonstrated that prognosis in 48 cases was good （64.0%）, 16 cases was moderate disability （21.3%）, 6 cases was severe disability （8.0%）, 2 cases was vegetative survival （2.7%）, 3 cases was in death （4.0%）. The cure rate was 64.0% and the overall good-prognosis rate was 85.3%. Conclusions Craniotomy and aneurysm clipping has a better surgical efficacy and a high cure rate in elderly patients with ruptured intracranial aneurvsm.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2013年第7期727-729,共3页
Chinese Journal of Geriatrics
关键词
颅内动脉瘤
神经外科手术
Intracranial aneurysm
Neurosurgical procedures
