颅内动脉瘤的显微手术治疗

MICROSURGICAL TREATMENT OF INTRA-CRANIAL ANEURYSMS

近２年固余选择性连续显微手术治疗８９例颅内动脉瘤，其中术前Ｈｕｎｔ－Ｈｅｓｓ分级，Ⅰ级２４例，Ⅱ级３８例，Ⅲ级１８例，Ⅳ级６例，Ⅴ级３例。３例在手术室内出血后立即手术治疗，３例在３天内手术，４３例在３～１４天内手术，４０例在出血后１４天以后手术。近期手术死亡率为３．３％。２年内总死亡率为５．６％，重残率为３．４％。临床证明显微手术技术的正确使用是颅内动脉瘤手术成功的关键。

AbstractBased on our no selected intracranial an-eurysms which were consecutively operatedupon under microscope whithin morethan two years, the relationships between theoperative results and patients' conditions priorto the operations and optimal time were ana- lyzed.According to Hunt-Hess classification,in our group there were grade I 2 4 cases,grade II 38.grade III 18,grade IV 6, gfadeV3. After hemorrhage, 3 cases were immedi-ately operated upon,3 cases within 3 days,43 cases within 3 to 14 days, 40 cases after14 days. In our group,the operative mortalityrate was 3.3%。 After a longterm follow- up study, we found that the total mortalityrate was 5.6%, the morbidity rate was 3.4%. The resulte show that properly using microneu-rosurgical technique and equipment are thekey for getting good results of surgical treat- ment of intracranial aneu rysms.Some opera- tive procedures and the prophylaxiS of cere- bral vasospasm during the operation are alsodiscussed in this paper.