颅内动脉瘤早期显微手术治疗的临床分析

目的探讨早期显微手术治疗破裂脑动脉瘤的疗效。方法对32例破裂脑动脉瘤早期显微手术治疗进行回顾性分析，按Hunt分级：Ⅰ级6例、Ⅱ级17例、Ⅲ级5例、Ⅳ级3例、Ⅴ级1例。入院后均行数字减影血管造影（DSA）诊断其中颈内动脉后交通动脉瘤13例，前交通动脉瘤19例，所有患者均在72小时以内手术并随访4～12月，生存质量根据日常生活能力（ADL）分级法。结果32例破裂动脉瘤均获夹闭。根据ADL分级法。〉60分27例，40-60分2例，〈40分1例，死亡2例。结论早期显微手术是治疗破裂脑动脉瘤的有效方法，能明显提高破裂脑动脉瘤的生存率和牛活质量。

Retrospective early microsurgery for intracranial aneurysm

Objective To investigate the therapeutic effect of early microsurgery for rupture intracranial aneurysms. Method thirty-two rupture intracranial aneurysms, per-formed early microsurgery from June 1996 to may 2004 were analysed retrospectively.According to Hunt and Hess classification ,6 cases were in grade Ⅰ,17 case in grade Ⅱ, 5cases in grade Ⅲ, 3 cases were in grade Ⅳ, 1 case were in grade Ⅴ, Site of rupture aneurysms diagnosed by digital subtraction angiography were AcoAA 19 cases, PcoAA 13 cases, All patients underwent microsurgery within 72 hours and were followed up from 4 to 12 months, Quality of life was observed at the classification of abitity of daily living (ADL).Result All of the 32 ruptured aneurysms were clipped successfully, 26 cases were classifiedas ADL outcome score more than 60 scores, 2 case ADL outcome score between 40～60 scores, and 1 case ADL outcome score less than 40 scores, two cases died. Conclusion early microsurgery is an dffective treatment for rupture intracranial anterior circulation cerebral aneurysms, which may sig-nificantly improve the survival rate and life quality of patients with ruptured cerebral aneurysms.