破裂大脑中动脉动脉瘤的急诊手术治疗

Emergency Surgical Treatment of Ruptured Middle Cerebral Artery Aneurysms

目的:报道15例大脑中动脉瘤急诊早期手术治疗的经验。方法:对2000年4月-2002年7月我院收治并行急诊手术治疗的15例大脑中动脉动脉瘤进行回顾性分析,其中位于M1-2段的有12例,M3-4段的有3例;HUNT-HESS分级Ⅱ-Ⅲ级12例,IV级2例,V级1例。结果:随访3个月-2年,除1例死亡,1例遗留偏瘫外,其余的均恢复优良。结论:对大脑中动脉瘤进行急诊早期手术能有效预防其致命的再次破裂出血,及时清除血肿及蛛网膜下腔出血,从而改善患者的预后。

Objective: To report the experience of emergency surgical treatment of ruptured middle cerebral artery aneurysms. Methods: 15 middle cerebral artery aneurysms treated by emergency operation in our hospital during April 2000 to July 2002 were reviewed retrospectively, among which 12 were located in M1-2 segment, 3 in M3-4 segment, and according to Hunt-Hess classification, 12 were of grade II-III, 2 of grade IV, 1 of grade V. Results: After a follow-up of 3 months to 2 years, all patients got excellent or good recovery except of 1 dying and 1 remaining mild hemiplegia. Conclusion: A emergency operative treatment of ruptured middle cerebral artery aneurysms can effectively prevent a second criminal rupture and evacuate intracerebral hematoma and subarachnoid hemorrhage in early time, thus improve the prognosis of the patients.