颅内动脉瘤早期破裂出血显微夹闭术的最佳手术时机研究

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1、颅内动脉瘤早期破裂出血显微夹闭术的最佳手术时机研究杨生军郝文炯张春满刘赞延安大学附属医院神经外科摘要：R的:探讨颅内动脉瘤早期破裂出血采用显微夹闭手术治疗的最佳时机。方法：选取本院心内科2010年1月2015年1月收治的90例颅内动脉瘤破裂出血患者进行回顾性分析，其中43例患者于出血后24h内进行显微夹闭手术治疗（24h组）、其余47例患者于2472h内进行显微夹闭手术（72h组），统计分析两组患者的围手术期情况及术后远期预后情况。结果:24h组患者术前动脉瘤再次破裂率0%显著低于72h组的12.77%,24h组与7

2、2h组患者术屮动脉瘤再次破裂、完全夹闭率差异无统计学意义;24h组术后3例患考发生脑梗死、4例患荠发生脑积水与72h组的6例脑梗死、8例脑积水比较差异•无统计学意义;24h组术后6个月达到预后良好的有36例、72h组预后良好的有31例，24h组患者预后良好率83.72%显著高于72h组的65.96%且差异具有统计学意义。结论:颅内动脉瘤早期破裂出血采用显微夹闭手术应该尽早治疗，24h

3、Aj治疗患者的预后较好。关键词：颅内动脉瘤;早期破裂;显微;夾闭手术;作者简介：刘赞,E-mail:yangshengjun_1981

4、@163.com收稿日期：2017-07-30StudyontheoptimaltimingofmicrosurgicalclippingofintracranialaneurysminearlystageYangSheng-junHaoWen-jiongZhangChun-manLiuYunDepartmentoOieurosurgeryiJY^nL^LJMiyer^lXyAffiliatedHospital;Abstract：ObjectiveToinvestigatetheoptimaltimingofsurg

5、icaltreatmentofearlyruptureandhemorrhageofintracranialaneurysms.MethodsSelectCardiologyhospitalinJanuary2010'anuary2015weretreated90casesofintracranialaneurysmrupturewereretrospectivelyanalyzed43patientsunderwentmicrosurgicalclippingsurgery(24hgroup)within24haf

6、terhemorrhage,theremaining47patientsunderwentmicrosurgicalclippingsurgery(72hgroup)within24'2h，statisticalanalysisofperioperativesituationsandlong-termpostoperativeprognosisofthetwogroupsofpatients.Results24hpreoperativegroupagainaneurysmrupturerateof0%wassigni

7、ficantlylowerthan72hgroup12.77%，24hand72hgrouppatientsintraoperativeaneurysmruptureagain,completeocclusionratewasnotstatisticallysignificant;24hgroup3patientswithcerebralinfarctionpatients,4patientswithcerebralinfarctionoccurredsixcasesofhydrocephalusand72hgrou

8、p，eightcasesofhydrocephalusbraincomparativedifferencewasnotstatisticallysignificant;24hgroupafter6monthstoachieveagoodoutcomeof36patients,72hgroupof31patientswithgoodprognosis,24hgroupofpatientswithgoodprognosisrateof83.72%wassignificantlyhigherthan65.96%andthe

9、differencewasstatisticallysignificant72hgroup.ConclusionEarlyruptureofintracranialaneurysmclippingsurgeryusingmicrosurgicaltreatmentshouldbeassoonaspossible,within24htreatme