破裂脑动脉瘤急诊术后防治脑血管痉挛的临床观察(附12例报道)

Clinical study on preventing cerebral vasospasm after emergency operation of ruptured intracranial a-neurisms

目的为寻求一种防治破裂脑动脉瘤急诊术后脑血管痉挛的效果确切、操作简便的方法。方法破裂脑动脉瘤急诊术后,脑底蛛网膜下腔置管,术后持续注入0.12%的罂粟碱稀释液10d,滴速2ml/h,术后第3d起腰穿放出血性脑脊液。结果12例破裂脑动脉瘤按Hunt-Hess分级,其中Ⅰ3例,Ⅲ级2例,Ⅳ级5例,Ⅴ级2例,恢复良好6例,轻度残废5例,重度残废1例。结论该方法操作简便,便于临床应用,防治脑血管痉挛效果确切,极大地改善了破裂脑动脉瘤患者的预后。

Objective To find an effective and simple method of preventing cerebral vasospasm after emergency operation of ruptured intracranial aneurisms. Methods After emergency operation of ruptured intracranial aneurisms, we set a vessel to perfuse 0.12% papaverine into subarachnoid around cerebral base cistern for 10 days Since the third day after surgery,release the CSF by puncturing.Rusults According to Hunt-Hess Grade,3 cases belonged to grade Ⅰ,2 grade Ⅱ, 5 grade Ⅲ and 2 grade Ⅳ.6 had good recovery,5 lightly disabled and 1 severely disabled.Conclusion It is a simple,effective and safe method to prevent cerebral vasospasm.