【摘要】 目的前循环高级别破裂动脉瘤手术中脑肿胀是影响手术效果的重要原因,文中探讨解决这一问题的方法。方法回顾性分析了2011年9月至2012年3月收治的51例中高级别动脉瘤性蛛网膜下腔出血(aneurismal subarachnoid hemorrhage,aSAH)病例,采用术中腰穿持续引流、脑室额角穿刺和清除血肿后再释放脑脊液3种方法以降低颅内压,利于显露、夹闭动脉瘤。结果动脉瘤全部夹闭,1个月后患者GOS评分:好(4~5分)25例(49.0%),差(2~3分)24例(47.1%),死亡(1分)2例(3.9%)。结论通过术中释放脑脊液的方法可取得良好的显露效果,顺利夹闭动脉瘤。更多还原

【Abstract】 Objective Brain swelling is an important factor that influences the operation effect of high-level ruptured aneurysm in the pre-willing circle. This paper discusses the methods to solve the problem. Methods We retrospectively analyzed 51 cases of high-level aneurysmal subarachnoid hemorrhage( aSAH) surgically treated from September 2011 to March 2012. In operation,we used intraoperative continuous lumbar puncture drainage,frontal ventricle puncture and removal of hematoma to release cerebrospinal fluid,reduce intracranial pressure and make it easier to expose and clip the tumors. Results All the aneurysms were clipped successfully. At 1 month after surgery,the GOS scores were 4-5 in 20 cases( 43. 4%),2-3 in 24 cases( 52. 2%),and 1 in 2 cases of death( 4. 3%). Conclusion Intraoperative release of cerebrospinal fluid can help to achieve good exposure and successful clipping of aneurysm.更多还原