颅内动脉瘤术中破裂的原因及应急处理措施

目的:探讨颅内动脉瘤术中破裂的原因及应急处理措施。方法:35例颅内动脉瘤行开颅夹闭手术。结果:本组术中破裂7例(麻醉诱导至切开硬脑膜时破裂1例,解剖粘连脑池、分离载瘤动脉时破裂2例,牵拉、剥离动脉瘤体及暴露、游离瘤颈时破裂3例,夹闭瘤颈时破裂1例)。其中5例经处理后顺利夹闭;2例术后死于脑疝。结论:术前降颅压及术中仔细操作、良好的暴露和主动截断载瘤动脉供血能减少破裂概率。

Analysis on Factors Involved in Intraoperative Intracranial Aneurysm Rupture

Objective:To find out causes and emergent management of intracranial aneurysmal rupture during operation.Methods: The clipping technique was performed in 35 patients with intracranial aneurysm.Results: One case aneurysm ruptured during the operation was from anesthesia induction to endocranium exposure,two cases were ruptured when the adhesive cistern was dissected and the parent artery was separated,three cases were ruptured when the body of aneurysm was dragged and the neck of aneurysm was dissected,one case was ruptured when the neck of aneurysm was clipped.Five in seven cases were treated successfully and two cases died of cerebral hernia.Conclusion: The rupture rate can reduce for decreasing pre-operational intracranial pressure,operating carefully,revealing the parent artery successfully and blocking blood flow of the parent artery initiatively.