48例颅内动脉瘤破裂出血急性期治疗效果分析

Treatment Experience of Acute Ruptured Intracranial Aneurysms

总结我科收治的48例颅内动脉瘤破裂出血急性期患者治疗体会。回顾性分析2011年8月～2013年10月我科收治的48例56个颅内动脉瘤破裂出血急性期临床资料，介入栓塞30例（36个动脉瘤），手术夹闭18例（20个动脉瘤）。结果介入栓塞组恢复良好14例、轻度残疾6例、重度残疾8例，死亡2例，手术夹闭组恢复良好10例、轻度残疾6例、重度残疾2例。两组 Hunt-Hess 分级3级以下患者预后无显著性差异。血管内栓塞和手术夹闭均为颅内动脉瘤破裂出血急性期的有效治疗手段，Hunt-Hess 分级3级以下者两种治疗方式均可得到满意疗效，4级以上者血管内栓塞是挽救患者生命的重要措施，但预后较差。

To summarize the treatment experience of 48 cases of acute ruptured intracranial aneurysms in our department . Retrospective analysis was done with the clinical materials of 48 cases with 56 acute ruptured intracranial aneurysms , which were management in our department during August 2011 to October 2013 .30 cases with 36 aneurysms were treated by endovascular embolization ,and 18 cases with 20 aneurysms were cured by microsurgery clipping .14 cases with good recovery ,6 cases with mild disability , 8 cases with severe disability , and 2 cases died in group of endovascular embolization .In other group of microsurgery clipping ,10 cases with good recovery ,6 cases with mild disability ,2 cases with severe disability . There was insignificant difference in the rates of good recovery between both the endovascular embolization and microsurgery clipping groups with Hunt-Hess scale below grade 3 . Both of the two methods , endovascular embolization and microsurgery clipping ,were valid treatment techniques .All cases with Hunt-Hess scale below grade 3 could be obtained with good curative effects ,and endovascular embolization would be the important methods to rescue the patients with Hunt-Hess scale above grade 4 ,but the prognoses were very poor .