126例颅内动脉瘤破裂的早期显微外科治疗

目的探讨早期显微外科手术治疗颅内动脉瘤破裂的疗效。方法126例颅内动脉瘤破裂患者根据Hunt—Hess分级，Ⅰ级20例、Ⅱ级37例、Ⅲ级42例、Ⅳ级18例、Ⅴ级9例。126例患者第一次手术均在出血后72h内，13例颅内多发动脉瘤患者进行了二次手术，所有患者术后用格拉斯哥评分表（GOS）随访1—3年。结果恢复良好98例；中度病残，但生活自理18例；重度病残，生活不能自理4例；植物生存1例；死亡5例。结论早期显微外科手术是治疗颅内动脉瘤破裂的有效方法，能改善动脉瘤患者的生存质量。

Early microsurgery for 126 ruptured intracranial aneurysms

Objective To investigate the therapeutic effect of early microsurgery for ruptured intracranial aneurysms. Methods According to Hunt and Hess classification, 20 cases were in grade Ⅰ,37 cases in grade Ⅱ ,42 cases in grade Ⅲ,18 cases in grade Ⅳ ,and 9 cases in grade Ⅴ respectively. 126 cases underwent firstly microsurgery within 72 h, and 13 cases of multiple intracranial aneurysms underwent secondly microsurgery. All cases were followed up from 1 year to 3 years through Glasgow Outcome Scale after operation. Results Good outcome was achieved in 98 cases, moderate disability in 18 cases, severe disability in 4 cases, persistent vegetative state in 1 case, and 5 patients died after surgery,respectively. Conclusion Early microsurgery is an effective treatment for ruptured intracranial aneurysms and can improve the life quality of patients with ruptured intracranial aneurysms.