[1]张清平,陈建良,冯文峰,等.前循环动脉瘤破裂并脑内血肿的显微手术治疗[J].临床神经外科杂志,2014,(02):118-121.
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前循环动脉瘤破裂并脑内血肿的显微手术治疗()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
期数:
2014年02期
页码:
118-121
栏目:
论著
出版日期:
2014-04-30

文章信息/Info

Title:
Microsurgical treatment for patients with ruptured aneurysms of anterior circlulation combined with intracerebral haematoma
作者:
张清平 陈建良 冯文峰 漆松涛 邱建东 游恒星 马珊 钟远强 练晓文 彭智涛
深圳市福田区人民医院神经外科
关键词:
颅内动脉瘤脑内血肿显微手术前循环
Keywords:
Intracranial Aneurysm Intracerebral hematomas Microsurgery Anterior circulating
分类号:
R651.1
文献标志码:
A
摘要:
目的 探讨前循环动脉瘤破裂伴脑内血肿手术方法及疗效。方法 前循环动脉瘤破裂并脑内血肿患者29例行显微手术治疗,总结其临床特点,包括动脉瘤部位、大小、形态,、合并脑内血肿大小、形态,术前Hunt-Hess分级、手术方式及三个月随访的格拉斯预后评分。结果 Hunt-Hess分级Ⅲ级10例、Ⅳ级17例、Ⅴ级2例。17例患者术前经常规血管造影、12例行三维CT血管造影(three-dimensionalCT angiography, 3D-CTA)检查证实。29例术中诊断与术前诊断一致,前交通动脉瘤6例,后交通动脉瘤7例,大脑中动脉瘤16例,29例患者共31枚动脉瘤均成功夹闭,3个月后随访时GOS评分Ⅴ级14例,Ⅳ级7例,Ⅲ级4例,Ⅱ级2例,Ⅰ级2例。结论 颅内前循环动脉瘤破裂并脑内血肿患者病情危重,早期夹闭动脉瘤,清除血肿,效果良好。
Abstract:
Objective To explore microsurgical techniques and curative effects of anterior circulation aneurysms with intracerebral haematoma. Methods  Twenty-nine patients with ruptured anterior circulation aneurysms with intracerebral hematoma, who underwent haematoma evacuation and aneurysmal clipping. summarize the clinical features, including the location, size, shape of the aneurysm, the combined intracerebral hematoma size, shape, preoperative Hunt-Hess grade, Glasgow Outcome Scales(GOS) in three-month follow-up. Results  Hunt-Hess grade Ⅲ 10 cases, Ⅳ 17 cases, Ⅴ two cases. 17 patients with preoperative digital subtraction angiography, 12 patients three-dimensional CT angiography (3D-CTA) confirmed. The microsurgical outcomes indicated that the intraoperative diagnoses were consistent with preoperative diagnoses in all cases. The ruptured aneurysms include six cases of anterior communicating artery aneurysms, seven posterior communicating artery aneurysms, and sixteen middle cerebral artery aneurysms. Twenty-nine patients with a total of 31 aneurysms were clipped successfully. Glasgow Outcome Scales(GOS) in three-month follow-up were grade ⅴ in 14 cases, grade Ⅳ in 7, grade III in 4, grade Ⅱ in 2, gradeⅠin 2. Conclusion  For patients with ruptured aneurysms of anterior circlulation combined with intracerebral hematoma, favorable outcome should be achieved through early clipping of the aneurysm, remove the hematoma.

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备注/Memo

备注/Memo:
[收稿日期] 2013-03-24
更新日期/Last Update: 2014-04-15