颅内动脉瘤的治疗与预后(附40例报告)

The treatment and prognosis of intracranial aneurysm (40 cases report)

为探讨颅内动脉瘤的治疗与预后 ,对 2 0 0 1年收治的 40例颅内动脉瘤进行临床分析 ,其中手术 35例 ,死亡 3例。随访 2个月 2例 ,均正常生活 ;随访 3个月～ 1年 2 8例 ,术后 GOS分级 : 级 2 1例 , 级 3例 , 级 3例 ,死于自发性脑干出血 1例。 2例失访。另未手术 5例 ,其中术前动脉瘤破裂死亡、再出血行栓塞治疗术后植物状态各 1例 ,自动出院 3例。认为自发性蛛网膜下腔出血患者应尽早行 DSA检查 ,确诊为动脉瘤后应尽早手术 ;早期手术的优点在于防止动脉瘤再次破裂出血和降低术后脑积水发生率 ;除动脉瘤再破裂出血外 ,脑梗塞和脑积水是影响预后的主要因素。

To explore the treatment and prognosis of intracranial aneurysm. clinical materials of 40 cases with intracranial aneurysm admitted in 2001,Among 35 cases of operation,3 cases.died,2 cases came back to normal work with 2-month follow up.28 cases followed up 3 months to 1 year,GOS respectirely Ⅴ 21 cases,Ⅳ 3 cases,Ⅲ 3 cases,1 case died of spontenous brain stem hemorrhage. 2 cases failed to follow up.In 5 cases without operation, 1 case died of rupture of aneurysm before operation, 1 case vegetative slate after embolization, 3 cases auto-discharge .We concluded that patients of sponteneous subarachnoid hemorrhage should be given digital subtraction anglography(DSA) examination as early as possible.When diagnosised aneurysm,earlier period operation should be carried out.The advantages of earlier period operation mainly are preventing rebleeding and decrease the incidence of hydrocephalus.Apart from aneurysm rebleeding,brain infarction and hydrocephalus are the other two important factors affecting the prognosis.