深低温停循环下行颅内动脉瘤手术围术期并发症及预后分析

The analysis of complication and outcoming of patients with deep hypothermic circulatory arrest in the operation of giant intracranial artery aneurysm

目的分析并探讨深低温停循环(DHCA)下行颅内巨大动脉瘤手术患者围术期并发症及预后。方法根据6例患者DHCA下行颅内巨大基底动脉瘤手术中脑氧饱和度(rSO2)以及体温、心电图等监测指标的变化和术后患者的转归和并发症发生情况,分析围术期的主要并发症及预后相关因素。结果在DHCA的条件下,6例患者术中均发生室颤等并发症。rSO2监测显示,虽然停循环期间rSO2明显降低,但不致引起全脑缺氧。本组6例患者术后不同程度地出现局部脑损伤表现,其中3例死亡。结论DHCA围术期可发生多种并发症,局部血管损伤致支配区功能异常是影响手术预后的重要因素,早期康复训练对患者有益。

ObjectiveTo analyze the complication and outcoming of patients with deep hypothermic circulatory arrest (DHCA) in the operation of giant intracranial artery aneurysm.MethodsThe main complications and factors related to outcoming of six patients undergoing resection of giant intracranial basilar artery aneurysm were analyzed according to cerebral oximetry (rSO_2), body temperature, electrocardiogram (ECG) during operation, and complications and outcoming after operation.ResultsUnder the condition of DHCA, complications such as ventricular fibrillation could not be avoided. Although circulatory arrest caused degrade of rSO_2, holo-brain oxygen deficiency caused by circulation arrest after operation was not happened in all six patients. Three patients were died after resection, and local brain injury occurred ins all six patients.ConclusionDHCA can induce multitude complication in the resection of giant intracranial artery aneurysm, local brain injury is the main factor of influencing the outcoming of patients and early rehabilitation is important to patients.