前循环破裂动脉瘤的急诊手术处理

Emergent Surgery for Ruptured Cerebral Anterior Circulating Aneurysms

目的:探讨前循环破裂动脉瘤的急诊手术效果及预后。方法:对2002年1月-2005年6月51例破裂动脉瘤的急诊手术病例进行分析。入院病情按照Hunt-Hess分级,术前先行螺旋CT平扫,再经股动脉插管数字减影全脑血管成像(DSA—CAG),显微手术处理动脉瘤和清除合并的颅内血肿。结果:共55个动脉瘤,夹闭51个,包裹4个。随访4个月～3年,良好者42例,中度残疾7例,植物生存1例,死亡1例。结论:对Ⅰ～Ⅳ级破裂动脉瘤患者,急诊手术效果良好。

Objective：To investigate the effect of emergent surgery on ruptured cerebral anterior circulating aneurysms. Methods：Fifty-one cases from January. 2002 to June. 2005 were analysed retrospectively. Each case was assessed according to Hunt-Hess grading. All the cases were treated with spiral CT scanning, 2 cases with spiral CT three-dimensional anglo-imaging, and 49 cases with transfemoral artery cannula for cerebral angiography（DSA-CAG）. All underwent microsurgical clipping or accurate evacuating intracraninal hematoma. Results： Of 55 cerebral anterior circulating aneurysms. 51 lesions was clipped suceufuly, and 4 were wrapped. Following up from 4 months to 3 years,42 cases had good recovery,7 cases suffered moderated disability, 1 case was living vegetatively, 1 case died. Conclusion： Emergent surgery could provide good effect on ruptured cerebral anterior circulating aneurysms of grade Ⅰ-Ⅳ.