后交通动脉瘤导致蛛网膜下腔出血的临床治疗研究

The Clinical Therapy Study of Posterior Communicating Artery Aneurysm Causing Subarachnoid Hemorrhage

目的:探讨颈内动脉后交通支动脉瘤导致蛛网膜下腔出血的治疗方法及临床效果。方法:回顾性分析本院2009-2014年期间收治的颈内动脉后交通支动脉瘤导致蛛网膜下腔出血的63例患者的临床资料。结果:63例患者中,动脉瘤夹闭术38例,中西医结合保守治疗14例,纯西医保守治疗11例。38例动脉瘤夹闭术患者中,治愈28例(73.7%),轻残6例(15.8%),中残2例(5.3%),重残1例(2.6%),死亡1例(2.6%)。14例中西医结合保守治疗患者,治愈4例(28.6%),轻残2例(14.3%),中残3例(21.4%),重残2例(14.3%),死亡3例(21.4%)。11例纯西医保守治疗患者,治愈2例(18.2%),轻残2例(18.2%),中残2例(18.2%),重残2例(18.2%),死亡3例(27.2%)。结论:后交通动脉瘤导致蛛网膜下腔出血的患者应早期进行病因治疗,以提高患者预后。后交通动脉瘤夹闭术治疗是临床上比较普及的病因治疗方法。与内科保守治疗相比较而言,后交通动脉瘤夹闭术治疗治愈率更高,且致死率和重残率均低于内科保守治疗,进行内科保守治疗时,最好选用中西医结合治疗方法。

Objective：To investigate the therapeutic method and clinical effect of posterior communicating aneurysm of internal carotid artery causing subarachnoid hemorrhage.Method：The clinical data of 63 patients with posterior communicating aneurysm of internal carotid artery causing subarachnoid hemorrhage in our hospital from 2009 to 2014 were retrospectively analyzed.Result：In 63 patients,38 cases were intracranial aneurysm clipping,14 cases were conservative treatment of integrated Chinese and Western medicine,11 cases were purely Western medicine conservative treatment.In 38 patients with Intracranial aneurysm clipping,28 cases（73.7%）were cured,6 cases（15.8%）were mild disability,2 cases（5.3%）were moderate disability,1 case（2.6%）were severe disability,1 case（2.6%）were died.In 14 cases of integrated Chinese and Western medicine,4 cases（21.4%）were cured,2 cases（14.3%）were mild disability,3 cases（21.4%）were moderate disability,2 cases（14.3%）were severe disability,3 cases（21.4%）were died.In 11 patients with pure medicine conservative treatment,2 cases（18.2%）were cured,2 cases（18.2%）were mild disability,2 cases（18.2%）were moderate disability,2 cases（18.2%）were severe disability,3 cases（27.2%） were died.Conclusion：The patients with posterior communicating artery aneurysm causing subarachnoid hemorrhage should be performed early etiological treatment,improve the prognosis of patients.Ipsilateral internal carotid artery ligation treatment is more popular clinical etiology treatment.Compared with conservative treatment,artery ligation treatment cure rate is higher,and mortality and severe disability rates are lower than the conservative treatment,when medical conservative treatment,preferably treated with combination of traditional Chinese and Western medicine approach.