颅内动脉瘤破裂早期的显微手术治疗

目的总结破裂早期显微手术治疗颅内动脉瘤的经验。方法回顾性分析2006年1月至2008年11月收治的126例颅内动脉瘤破裂出血后早期（3d之内）经受了显微外科治疗患者的临床资料。126例患者共135个动脉瘤中，130个行瘤颈夹闭术，5个行动脉瘤包裹术，术中动脉瘤破裂21例。结果出院时按GOS评分评定手术疗效，恢复良好106例；4例中度病残，但生活能自理；8例重度病残，生活不能自理；3例植物生存；5例死亡。结论娴熟的显微外科技术是颅内动脉瘤早期手术成功的重要保证。颅内动脉瘤破裂一经确诊，在条件允许下应尽早手术夹闭动脉瘤，早期手术能减少再出血，降低死亡率和致残率。

Early Micrusurgery for Ruptured Intracraulal Aneurysm

Objective To summarize the experiences in treating intracranial anenrysms with microsurgery early after the rupture. Methods The clinical data of 126 intracranial aneurysms patients with subarachnoid hemorrhage （SAH）, who underwent microsurgery early （within 3 days） after the rupture in our hospital from January, 2006 and November, 2008, were analyzed retrospectively. Of 135 intracranial aneurysms in 126 patients, 130 were clipped and 5 wrapped. Results According to GOS, of 126 patients with intracranial aneurysms, 106 were recovered well, 4 were moderately disabled, 8 were severely disabled, 3 vegetatively survived, and 5 died after the surgery. Conclusions Skillful microsurgical technique is highly important to enhancing the success rate of microsurgery for intracranial aneurysms. Once the definite diagnosis is made, the operation should be performed as early as possible in the patients with intracranial aneurysms. Early microsurgery for ruptured intracranial aneurysms can decrease reblooding, disabled rate and mortality.