显微手术治疗动脉瘤合并颅内血肿的临床观察

Clinical study on microsurgery for aneurysm complicated with intracranial hematoma

目的观察经显微手术治疗动脉瘤合并颅内血肿后的临床效果。方法选取某医院2014年8月-2018年8月收治的动脉瘤合并颅内血肿的患者70例,男患者44例,女患者26例;早期手术患者34例,大于72 h的晚期手术患者36例。Hunt-Hess分级:Ⅰ级患者16例,Ⅱ级患者18例,Ⅲ级患者17例,Ⅳ级患者11例,V级患者8例,经显微手术治疗后以格拉斯哥恢复评分(glascow outcome scale,GOS)为标准,评价患者的预后情况。结果术前HuntHess分级较低的患者预后良好率较高,显微手术治疗效果良好;早期手术患者预后情况较好,患者的脑梗死率较低,平均手术时间和平均住院时间均较短。结论显微手术治疗动脉瘤合并颅内血肿有着较好的临床效果,Hunt-Hess分级症状较轻的患者经显微手术治疗效果较佳,尽早手术能有效预防动脉瘤合并颅内血肿的脑梗死情况,值得临床借鉴和推广。

Objective To study the clinical effect of the microsurgery for aneurysm complicated with intracranial hematoma.Methods From August 2014 to August 2018,70 patients with aneurysm complicated with intracranial hematoma were selected,including 44 male patients and 26 female patients.Totally 34 patients underwent early surgery and 36 patients underwent late surgery for more than 72 h.The Hunt-Hess classification showed that there were 16 patients with Grade I,18 patients with Grade II,17 patients with Grade III,11 patients with Grade IV and 8 patients with Grade V.After the microsurgical treatment,the prognosis of the patients was evaluated according to the Glascow outcome scale(GOS).Results The patients with low Hunt-Hess grade had a higher good prognosis rate and the therapeutic effect of the microsurgical treatment was good.The patients receiving the early surgery had a good prognosis,their cerebral infarction rate was low,and the average operation time and average hospitalization time were shorter.Conclusion The microsurgery has a good clinical effect in the treatment of aneurysm complicated with intracranial hematoma.The patients with mild Hunt-Hess grading symptoms have better therapeutic effect through microsurgery,and the patients undergoing early surgery have better postoperative recovery.Early surgery can effectively prevent cerebral infarction of aneurysm complicated with intracranial hematoma,which is worthy of clinical reference and promotion.