大脑中动脉瘤破裂并血肿的急诊治疗

Emergency Treatment of Ruptured Middle Cerebral Aneurysm with Hematoma

目的:探讨对大脑中动脉瘤破裂并血肿患者的急诊治疗措施及临床效果。方法:2018年1-12月收治急诊确诊为大脑中动脉瘤破裂并血肿患者38例,均采取开颅手术治疗,归纳对大脑中动脉瘤破裂并血肿患者急诊治疗具体操作与病情控制效果。结果:所有患者均顺利完成手术,术中夹闭动脉瘤38例,术后对患者进行CTA检查,均提示动脉瘤夹闭满意,载瘤血管基本通畅。死亡6例。结论:对急诊收治大脑中动脉瘤破裂患者在确认病情后要立即采取有效手术方案清除血肿,将动脉瘤夹闭,同时配合去骨瓣加压措施为患者术后康复提供保障。

Objective:To explore the emergency treatment and clinical effect of ruptured middle cerebral aneurysm with hematoma.Methods:From January to December 2018,38 patients with ruptured middle cerebral aneurysm and hematoma were selected and treated by craniotomy.The specific operation and disease control effect of emergency treatment for patients with ruptured middle cerebral aneurysm and hematoma were summarized.Results:All patients completed the operation successfully.38 cases of aneurysms were clipped during the operation.CTA examination of the patients after operation showed that the clipping of the aneurysms was satisfactory and the parent vessels were basically unobstructed.6 cases died.Conclusion:The emergency treatment of patients with ruptured middle cerebral aneurysm should take an effective surgical plan to remove the hematoma immediately after confirming the condition,clamp the aneurysm,and at the same time provide a guarantee for the postoperative rehabilitation of the patients with bone flap decompression。