摘要
目的探讨大脑中动脉动脉瘤破裂合并脑内血肿早期手术的疗效和经验。方法回顾性分析近5年9例大脑中动脉动脉瘤破裂合并脑内血肿患者,早期手术行动脉瘤夹闭及血肿清除术的治疗效果。7例患者术前经常规血管造影或(和)三维CT血管造影(three-dimensional CT angiography,3D-CTA)检查证实,2例患者行CT检查直接手术。术中使用微血管多普勒超声辅助显露动脉瘤及检查动脉瘤夹闭前后载瘤动脉血流。结果 9例患者共10枚动脉瘤均成功夹闭,3个月后随访时GOS评分恢复良好者4例,中度病残2例,重度病残2例,植物生存1例。结论大脑中动脉动脉瘤破裂合并脑内血肿患者病情危重,早期手术能有效改善预后,3D-CTA和术中多普勒超声等无创检查措施能为手术提供帮助。
Objective To summarize the experience and effectiveness of early surgical treatment of middle cerebral artery （MCA） aneurysms associated with intracerebral haematoma. Methods Nine patients with ruptured MCA aneurysms associated with intracerebral haematoma, who underwent haematoma evacuation and aneurysmal clipping, were retrospectively reviewed. Preoperative conventional angiography or/and three-dimensional CT angiography （3 D-CTA） was performed in seven patients. Another two patients underwent urgent surgery after CT scanning. Intraoperative Doppler sonography was used to assist exposure of aneurysms and parent vessels before and after aneurysm clipping. Results Ten aneurysms in nine patients were clipped. GOS at three months was good recovery in four cases, moderate disability in two, severe disability in two, and persistant vegetative state in one. Conclusion Acceptable outcome may be achieved in the patients with ruptured MCA aneurysms associated with intracerebral haematoma after early surgery. 3D-CTA and intraoperative Doppler sonography are helpful for surgical treatment.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2008年第24期2324-2326,共3页
Journal of Third Military Medical University
基金
"十一五"国家科技支撑计划(2006BAI01A12)
the Major Program of the"Eleventh Five-Year Plan"for Sci &Tech Research of China (2006BAI01A12)
关键词
颅内动脉瘤
大脑中动脉
脑内血肿
显微外科手术
intracranial aneurysm
middle cerebral artery
intracerebral hematoma
microsurgery
作者简介
陈志，男，湖南省隆回县人，副主任医师，主要从事脑及脊髓血管病的显微手术及介入治疗方面的研究，发表论文28篇。电话：（023）68765759．E-mail：chenzhi@xinhuanet．com
通信作者：朱刚，电话：（023）687665261
