破裂前循环动脉瘤合并颅内血肿的显微手术治疗

Microsurgical treatment for patients with ruptured anterior circulation aneurysm combined with intracranial hematoma

目的探讨破裂前循环动脉瘤合并颅内血肿的治疗策略和经验。方法通过显微手术治疗破裂前循环动脉瘤合并颅内血肿35例,于超早期、早期手术,清除血肿同时夹闭责任动脉瘤,回顾性分析其临床资料及疗效。结果 35例均成功夹闭。手术效果按GOS评分:V级22例,IV级6例,III级3例,II级2例,I级2例。结论超早期手术,合理设计手术切口,必要时去骨瓣减压,术中操作得当,可使破裂前循环动脉瘤合并颅内血肿患者得到满意治疗。

Objective To explore the methods and experiences in treatment of ruptured aneurysms of anterior circulation combined with intracranial hematoma. Methods A total of 35 patients with ruptured aneurysms of anterior circulation combined with intracranial hematoma were treated through microsurgery. All surgeries were accomplished during ultra- early or early time. The intracranial hematoma was cleared and the aneurysm was clipped at the same time. The data were analyzed retrospectively. Results All aneurysms in the 35 patients were clipped successfully. Postoperative Glasgow Outcome Scale showed grade V in 22,grade IV in 6,grade III in 3,grade II in 2,and grade I in 2 patients. Conclusion Ultra- early microsurgery,reasonable approach,essential craniotomy and proper operation could lead to good recovery for patients with ruptured aneurysms of anterior circulation combined with intracranial hematoma.