摘要
目的探讨前循环破裂动脉瘤早期手术治疗的方法和疗效。方法回顾性分析整群选取的该院2013年4月—2015年5月收治的71例破裂动脉瘤手术治疗患者病例资料,按Hunt-Hess分级,其中Ⅰ-Ⅲ级58例,Ⅳ-Ⅴ级13例;所有患者均在发病后72 h内早期行显微手术夹闭,以格拉斯哥预后评分量表（GOS）对患者进行神经功能评分。结果 71例患者均在显微镜下行手术夹闭,影像学检查共发现动脉瘤74个,3例为多发动脉瘤,5例宽颈动脉瘤均使用两个动脉瘤夹共同夹闭,所有病例均一期夹闭。术后6个月GOS评分,预后良好（5分）55例（77.5%）,轻残（4分）4例（5.6%）,重残4例（5.6%）,植物生存3例（4.2%）,死亡5例（7.0%）。结论前循环破裂动脉瘤早期积极显微手术可有效改善预后,提高生存质量。
Objective To investigate the therapeutic effect of early microsurgery for ruptured intracranial anterior circulation aneurysms. Methods Seventy-one cases with ruptured intracranial anterior circulation aneurysms undergoing surgery in our department from April 2013 to May 2015 were analyzed retrospectively. According to Hunt and Hess classification, 58 cases were in grade I-Ⅲ and 13 cases in grade Ⅳ-Ⅴ.All patients underwent microsurgery for clipping within 72 hours after onset. The neurological functions were scored according to Glasgow Outcome Scale（GOS）. Results All of the 71 patients with ruptured intracranial anterior circulation aneurysms were clipped successfully. Imaging examination showed that there were a total of 74 aneurysms. Three cases with multiple aneurysms, 5 cases with wide-necked aneurysms were treated by clipping two aneurysms together. One-stage clipping was achieved in all the patients. GOS 6 months after surgery showed good outcome（5 points） in 55 cases（77.5%）, mild disability（4 points） in 4 cases（5.6%）, severe disability in 4 cases（5.6%）, persistent vegetative state in 3 cases（4.2%）, and death in 5 cases（7.0%） after surgery. Conclusion Early microsurgery is an effective treatment for ruptured intracranial anterior circulation cerebral aneurysms, which may significantly improve the survival rate and life quality of the patients.
出处
《中外医疗》
2016年第4期27-28,31,共3页
China & Foreign Medical Treatment
关键词
前循环
颅内动脉瘤
蛛网膜下腔出血
早期显微手术
临床疗效
Anterior circulation
Intracranial aneurysm
Subarachnoid hemorrhage
Early microsurgery
Clinical curative effect
