颅内动脉瘤夹闭术后死亡19例分析

目的了解动脉瘤术后患者死亡的原因及危险因素。方法对1999-2008年在我院动脉瘤开颅夹闭手术后死亡的19例患者进行回顾性分析。19例患者术前经DSA检查确诊为动脉瘤。结果 19例患者于术后1～34d死亡,11例考虑死于术后出血,其中8例经术后CT确认。10例患者术后持续昏迷,考虑术中损伤重要血管。结论动脉瘤夹闭困难,动脉瘤开颅夹闭术后出血、重要血管损伤是患者术后死亡的重要原因,血管痉挛、脑积水、全身并发症会增加手术病死率。

Analysis of 19 deaths after intracranial aneurysm clipping

Objective To identify reasons and risk factors of postoperative mortality in intracranial aneurysm clipping patients. Methods A retrospective analysis of 19 patients who died after aneurismal clipping operations was performed. The diagnosis was confirmed by digital subtraction angiography (DSA). Results The patients died between 1 to 34 days after surgery. 11 were died of postoperative bleeding, 8 were confirmed by CT scan. 10 patients were in sustained coma after surgery, damage to essential arteries was considered to be the causes. Conclusions Difficulty in clipping, postoperative bleeding and damage to essential arteries are the primary reasons of post-operative deaths. Vascular spasm, hydrocephalus and systemic complications are contributing factors to surgical mortality.