显微外科手术治疗50例急性期颅内动脉瘤疗效分析.docVIP

显微外科手术治疗50例急性期颅内动脉瘤疗效分析 　　摘 要 目的：对显微外科手术治疗急性期颅内动脉瘤的疗效进行探讨分析。方法：选取采用显微外科手术治疗的颅内动脉瘤患者50例随访12个月，对手术时间、术中出血量、手术效果及术后并发症情况进行记录分析。结果：随访12个月，2例死亡，死亡率为4%；所有患者均手术成功，平均手术时间（61.1±17.6）min，平均术中出血量（45.1±16.8）ml。术后6个月预后良好率显著优于术后3个月，术后12个月预后良好率显著优于术后6个月。术后1例患者出现肺部感染，1例患者出现迟发性缺血性障碍。结论：急性期颅内动脉瘤患者采用显微外科手术法进行治疗，具有预后好、死亡率低、无严重并发症等优点。 　　关键词 颅内动脉瘤 急性期 显微外科手术 　　中图分类号：R651.12 文献标识码：B 文章编号：1006-1533（2017）13-0040-02 　　Clinical effect of microsurgery in the treatment of 50 cases of acute intracranial aneurysm 　　XIONG Haiyang 　　（Department of Neurosurgery， Xinyang Central Hospital， Xinyang 464000， China） 　　ABSTRACT Objective： To investigate the effect of microsurgery on intracranial aneurysms at acute stage. Methods： Fifty patients with intracranial aneurysms treated with microsurgery were selected and followed up for 12 months. The operation time， the bleeding volume， the efficacy of operation and postoperative complications were analyzed. Results： After 12 months of follow-up， there were 2 patients died with 4% mortality. All patients were successfully operated and the average operation time was （61.1±17.6） min， and the average intraoperative bleeding volume was （45.1±16.8） ml. The rate of good prognosis was higher at 6 months after operation than 3 months after operation and 12 months after operation than the 6 months after operation. There were one patient occurred postoperative pulmonary infection and another one the delayed ischemic disorder. Conclusion： Microsurgical treatment of intracranial aneurysms at acute stage possesses such advantages as good prognosis， low mortality and no serious complications. 　　KEY WORDS intracranial aneurysm； acute phase； microscopic surgical treatment 　　颅内动脉瘤主要指发生于颅内动脉管壁上的异常膨出，其主要临床症状为意识障碍、剧烈头痛、可能伴有神经功能障碍。近年来随着影像学、显微神经外科技术的飞速发展，大大降低了颅内动脉瘤手术的风险，提高了患者预后。本研究就我院采用显微外科手术治疗急性期颅内动脉瘤的结果及经验总结进行汇报。裂3 d之内为急性期）。所有患者均经过头颅计算机断层扫描（computed tomography， CT）、磁共振成像（magnetic resonance imaging， MRI）及数字减影血管造影（digital subtraction angiography， DSA）检查确诊为动脉瘤[1]。主要临床症状：突发剧