破裂前交通动脉瘤的早期显微手术治疗

目的总结破裂前交通动脉瘤早期显微手术治疗经验。方法回顾分析我院2007年12月～2010年12月48例前交通动脉瘤破裂患者临床资料，包括临床分级、手术时间及疗效等。结果24h内手术12例，24～48h手术30例，48～72h手术6例，术中均成功夹闭动脉瘤颈；术后死亡3例，中等残废3例，1例轻微神经功能障碍，恢复良好11例，完全康复30例。结论早期手术治疗前交通动脉瘤可明显降低再出血率及改善患者预后，术中颅压的控制、娴熟的显微操作技术及术后并发症的预防是成功的关键。

Early microsurgical treatment of ruptured anterior communicating aneurysms

Objective To summarize the experiences of early microsurgical treatment of ruptured anterior communicating aneurysms(ACA).Methods Retrospective analyses of clinical data were made in 48 cases of ruptured ACA from December 2007 to December 2010,which included clinical grading,surgical time,and curative effects,etc.Results Twelve cases,30 cases,and 6 cases received the surgical operation within 24 h,24 to 48 h,and 48 to 72 h,respectively,and all the necks of aneurysm were successfully clipped.Three cases died postoperatively.There were 3 cases of moderate disability,1 case of mild neurological dysfunction,11 ones with good recovery,and 30 ones with complete recovery.Conclusion Early microsurgical treatment of ruptured anterior communicating aneurysms can dramatically reduce the rate of rehaemorrhagia and improve the prognosis.Control of intracranial pressure during the operation,refined micromanipulative skill,and the precaution of postoperative complications are keys for successful treatment.