显微手术治疗颅内动脉瘤60例报告

Microsurgical treatment of ruptured intracranial aneurysms (a report of 60 cases)

目的研究破裂颅内动脉瘤的手术技巧及治疗策略。方法回顾性分析2005年9月至2008年12月经显微外科手术治疗的60例破裂颅内动脉瘤患者的临床资料。术前患者病情Hunt-Hess分级Ⅰ级15例,Ⅱ级15例,Ⅲ级13例,Ⅳ级9例,V级8例。结果所有动脉瘤均成功实施夹闭。术后GOS评分1分12例,2分8例,3分9例,4分14例,5分17例。结论颅内动脉瘤破裂后宜尽早行脑血管造影检查和手术治疗,正确的局部分离操作可减少动脉瘤术中破裂的危险和术后并发症的发生,积极的抗血管痉挛治疗是关系预后的重要环节。

Objective To study the microsurgical technique and treatment strategy of ruptured intracranial aneurysms. Methods The clinical data of 60 patients with ruptured intracranial aneurysms who underwent microsurgery from September, 2005 to December, 2009 was analyzed retrospectively. According to Hunt-Hess grading before the surgery, of 60 patients with ruptured intracranial aneurysms, 15 belonged in grade Ⅰ, 15 in grade Ⅱ, 13 in grade Ⅲ, 9 in grade Ⅳ, 8 in grade V. Results All the aneurysm necks were successfully clipped. GOS was 1 point in 12 patients, 2 in 8, 3 in 9, 4 in 14, 5 in 17. Conclusions The angiography and surgery should be done as soon as possible in the patients with ruptured intracranial aneurysms. The intraoperative rupture and postoperative complications can be reduced by the skillful surgical technique and the prognosis may be improved by a positive anti-vasospasm therapy in the patients with ruptured intracranial aneurysms.