颅内动脉瘤破裂伴脑内血肿的急诊显微手术治疗

目的探讨急诊显微手术治疗颅内动脉瘤破裂伴脑内血肿的经验。方法回顾性分析40例急诊行动脉瘤显微夹闭及患者术前仅行了头颅CT检查。结果40例患者共46个动脉瘤均成功夹闭,3月～4.5年随访无再出血症状发生。3个月后随访时进行GOS评分,5分30例,4分5例,3分4例,2分1例。30例患者经DSA或3D-CTA复查,均未见再出血。结论对颅内动脉瘤伴脑内血肿的患者早期采取显微手术,能有效改善预后。3D-CTA的应用能为此类患者的急诊手术和术后复查提供帮助。

Emergency Microsurgery for Ruptured Intracerebral Aneurysms Accompanied with Intracerebral Hematomas

Objective To evaluate the curative effect of microsurgery on the patients with ruptured intracerebral aneurysms accompanied with intracerebral hematomas, who underwent emergency microsurgery in our department, were analyzed retrospectively. CT examination was performed in all the patients and DSA and/or 3D-CTA was done in 34 patients before the operation. Results There were 46 aneurysms, which were clipped, in 40 patients. The hematomas were evacuated in all the patients. Rebreeding did not recur in all the patients. Rebreeding did rot recur in all the patients during following-up from 3 months to 4.5 years. According to GOS 3 months after the operation, of 40 patients, 30 were recovered well, 5 moderate disabled, 4 severely disabled, and 1 was vegetatively survived. Conclusions The curative effect of the emergency microsurgery on the patients with ruptured intracerebral aneurysms accompanied with intracerebral hematomas, in whom 3D-CTA is helpful to the emergency microsurgery, is good.