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[蛛网膜下腔出血急性期动脉动脉瘤的外科治疗]

[The surgical treatment of arterial aneurysms in the acute period of subarachnoid hemorrhage].

作者信息

Lebedev V V, Krylov V V, Saribekian A S, Shelkovskiĭ V N, Karamyshev R A, Evzikov G Iu, Zakharov A G, Aminov M A, Gushcha A O, Miatchin M Iu

出版信息

Zh Vopr Neirokhir Im N N Burdenko. 1995 Apr-Jun(2):3-9.

PMID:7625141
Abstract

The paper presents the surgical outcomes of 300 patients with brain arterial aneurysms. A total of 43% of the patients were admitted to the unit within the first 72 hours of the onset of hemorrhage, 165 patients were operated on within the first fortnight, 135 were operated on in later periods. The aneurysms of the anterior communicating artery, internal carotid, middle cerebral artery were 42, 24, and 22%, respectively. Multiple aneurysms were 12% according to the Hunt and Hess classification, the preoperative severity of the patients was as follows: Degree I, 39 (13%), patients, Degree II, 130 (43%), Degree III, 106 (36%), Degree IV, 18 (6%), Degree V, 7 (2%). In 14% of the patients, aneurysm rupture was accompanied by the formation of intracerebral hematoma. The qualitative analysis of angiograms revealed vascular spasm in 70% of cases, the quantitative one indicated it in 80%. Aneurysm clipping was performed in 269 patients, its wrapping with a free muscle flap was done in 31 patients. Among the patients operated on, the mortality was 35% in the first fortnight of the onset of the disease and 17% during operations in later periods.

摘要

本文介绍了300例脑动脉瘤患者的手术结果。共有43%的患者在出血发作后的72小时内入院,165例患者在发病后的头两周内接受了手术,135例患者在后期接受了手术。前交通动脉、颈内动脉、大脑中动脉的动脉瘤分别占42%、24%和22%。根据Hunt和Hess分级,多发动脉瘤占12%,患者术前严重程度如下:I级,39例(13%);II级,130例(43%);III级,106例(36%);IV级,18例(6%);V级,7例(2%)。14%的患者动脉瘤破裂伴有脑内血肿形成。血管造影的定性分析显示70%的病例存在血管痉挛,定量分析显示80%的病例存在血管痉挛。269例患者进行了动脉瘤夹闭术,31例患者采用游离肌瓣包裹动脉瘤。在接受手术的患者中,发病后头两周内的死亡率为35%,后期手术期间的死亡率为17%。

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