出血性颅内动脉瘤患者延期手术治疗存在的相关问题探讨

Discussion of the issues related to patients with ruptured intracranial aneurysms before delayed operation

目的了解出血性颅内动脉瘤患者延期手术治疗存在的相关的危险因素。方法对2002年至2010年收治的89例出血性颅内动脉瘤患者的临床资料,特别是在住院等待手术期间的临床资料进行回顾性分析。结果 89例出血性动脉瘤患者在延期手术期间并发动脉瘤再次破裂出血9例(10.11%),脑血管痉挛25例(28.09%),脑积水15例(16.85%)。术后按GOS评分,恢复良好66例,中残12例,重残4例,死亡7例;病残率17.98%,死亡率7.87%。结论出血性颅内动脉瘤患者在延期手术治疗期间动脉瘤再破裂出血、脑血管痉挛及脑积水发生率高,应采取多方面措施积极干预,才能提高其治愈率、降低死亡率和致残率。

Objective To study the risk factors related to patients with ruptured intracranial aneurysm before the delayed operation. Methods The clinical data of 89 patients with ruptured intracranial aneurysms, who were treated from 2002 to 2010, were analyzed retrospectively, especially related to rebleeding, cerebral vasospasm and hydrocephalus before the delayed operation. Results The rupture and bleeding recurred in 9 patients, cerebral vasospasm occurred in 25 and hydrocephalus occurred in 15 before the delayed operation. Of 89 patients with ruptured aneurysms undergoing the delayed operation, 66 were recovered well, 12 medially disabled, 4 severely disabled and 7 died. Conclusion The incidence of rebleeding, cerebral vasospasm and hydrocephalus are very high in patients with ruptured intracranial aneurysm before the delayed operation. Multiple measures to treat should be taken to increase the cure rate and decrease the morbidity and mortility.