颅内动脉瘤的急诊手术治疗分析-外科学(神经外科)专业论文.docxVIP

浙江大学医学院 浙江大学医学院 硕士学位论文 Emergent surgical treatment of intracranial aneurysms Department ofNenrosurgery,the Second Affiliated Hospital， School ofMedicine，ZheJiang University Postgraduate：Yang Peng—fei Supervisior：Prof．Chen Gao Abstract objecfive To analyse the results of emergent micro-neurosurgieal treatment for intraeranial uneurysms． Methods Ten cases with intmcrunial uneurysms undergoing emergent sw西cal treatment were retrospectively reviewed．And a follow-up study Was performed． Results The average interval between the onset of symptoms and admission to hospital is 8．1 hours；Between admission and the emergent surgical treatment is 18 hours；SO mean time from the onset to surgery is 26．1 hours．All 10 patients’intracranial aneurysms did not ruptured during operation．Postoperatively two cases(20％)were eomplicaled with cerebral vasospasm，one(10％)of which had isehemic symptoms；one case(10叼with communicating hydrocephalus after one month；one ease(10％)、)lritll suspected rebleeding ofuntreated anenrysm who Was diagnosed as multiple aneurysms and died suddenly．The complication rate Was significantly lower than patients undergoing late surgery．The prognosis was evaluated by Glasgow oumome scoring(GOs)system．Patients scoring 4 points and 5 points account for 80％．The prognosis Was better than that ofpatients with late surgery． Conclusion Aneurysmal subarachnoid hemorrhage is a common neurosurgical emergency．Emergent surgical treatment guided by cerebrovascular CTA(computed tomographic angiography)Call significantly reduce the risk of complications such as rebleeding and cerebral vasospasm．as well as the morbidity 3 浙江大学医学院 浙江大学医学院 硕士学位论文 and death rate，and improve the prognosis ofpatients subsequently Key words Intracranial aneurysms；subarachnoid hemorrhage；cerebral 4 浙江大学医学院 浙江大学医学院 硕士学位论文 丽舌 颅内动脉瘤是由于血流动力学等因素导致的脑血管瘤样突起，其自发性破 裂致蛛网膜下腔出血(subarachnoi