| 颅内动脉瘤术后脑血管痉挛的综合治疗 |
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| 引用本文： | 段安安 丁育基. 颅内动脉瘤术后脑血管痉挛的综合治疗[J]. 中华外科杂志, 1996, 34(6): 361-363 |
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| 作者姓名： | 段安安 丁育基 |
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| 作者单位： | 首都医科大学宣武医院神经外科 |
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| 摘 要： | 为了总结颅内动脉瘤术后脑血管痉挛的治疗方法，作者对４６例颅内动脉瘤术后合并脑血管痉挛和延迟性脑缺血的病例，以经颅多普勒（ＴＣＤ）、血清渗透压、颅内压、多项指标动态监测和神经病学追踪双重手段，进行个体化分级监护治疗。用ＴＣＤ监测脑血流速度，将脑血管痉挛为轻、中、重度，并依此标准采用钙离子通道阻断剂和扩容、血液稀释及高血压疗法进行治疗。４４例（９５．６％）术后血管痉挛和延迟性脑缺血完全恢复，有２例（４．３％）并发延迟性脑缺血神经功能障碍。作者还就ＴＣＤ分级、多项监控指标监测的价值和综合治疗相关问题进行讨论。
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| 关 键 词： | 脑动脉瘤 脑缺血.暂时性 超声检查.多普勒 |
Comprehensivetreatmentofintracranialaneurysmcomplicatedbypostoperativevasospasm |
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| DuanAnan,DingYuji,HuaYang,et al.. Comprehensivetreatmentofintracranialaneurysmcomplicatedbypostoperativevasospasm[J]. Chinese Journal of Surgery, 1996, 34(6): 361-363 |
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| Authors: | DuanAnan DingYuji HuaYang et al. |
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| Affiliation: | DuanAnan,DingYuji,HuaYang,etal.DepartmentofNeurosurgery,XuanwuHospital,CapitalUniversityofMedicalSciences,Beijing100053. |
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| Abstract: | Fortysixpatientssuferedfromintracranialaneurysmcomplicatedbypostoperativeva-sospasmanddelayedcerebralischemiaweremonitoreddynamicalybothbyclinicalobservationofneu-rologicstatusandmultipleitemssuchastranscranialDoppler,serumosmolality,intracranialpressureandothersomaticphysiologicitemsrelatedtomonitoring.Patientswereintensivelyandcomprehensiv-elytreatedaccordingtoindividualizedgradingofvasospasm.Fortyfourpatients(95.6%)werecom-pletelyrecovredfrompostoperativevasospasmanddelayedcerebralischemia,while2patients(4.3%)complicatedbyhemipalsyasaconsequenceofdelayedcerebralischemia.Theoccurrenceofvasospasmanddelayedcerebralischemia,thecriteriaofTCDgrading,thevaluablenessofmultiplephysiologicitemsandproblemsrelatedtocomprehensivetreatmentarediscussed. |
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| Keywords: | CerebralanurysmCerebralischemia transientUltrasonography Doppler |
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