【摘要】 目的探讨前循环破裂动脉瘤的急诊手术效果。方法表现为自发性蛛网膜下腔出血的前循环破裂动脉瘤患者51例,病情按照Hunt-Hess分级,先行CT平扫及三维CT血管成像,再经数字减影全脑血管造影。急诊手术处理动脉瘤,并清除颅内血肿。结果影像学检查共检出动脉瘤55个,其中颈内动脉-后交通动脉动脉瘤26个,前交通动脉动脉瘤20个,大脑中动脉动脉瘤5个,颈内动脉-脉络膜前动脉动脉瘤4个。动脉瘤手术夹闭51个,包裹治疗4个。随访4~36个月,转归良好者42例,中度残疾7例,植物状态1例,死亡1例。结论对Hunt-Hess分级Ⅰ~Ⅳ级的前循环破裂动脉瘤患者,急诊手术效果良好。更多还原

【Abstract】 Objective To explore the effect of emergency operation of ruptured anterior circulation aneurysms.Methods Fifty-one patients with ruptured anterior circulation aneurysms,who present with spontaneous subarachnoid hemorrhage(SAH),were classified according to Hunt-Hess grade.All patients had CT scanning and three-dimensional spiral CT angiography(CTA) first,and then they had global digital subtraction angiography.The aneurysms were treated with emergent surgery and evacuation of intracranio-hematoma.Results Fifty-five aneurysms were detected by CTA,among them 26 were internal carotid-posterior communicating artery aneurysms,20 were anterior communicating artery aneurysms,5 were middle cerebral artery aneurysms,and 4 were internal carotid-anterior choroidal artery aneurysms.Fifty-one aneurysms were clipped,and 4 were wrapped.The follow up period was 4 to 36 months,42 patients had good outcome,7 had moderate disability,1 lived in a vegetative state,and 1 died.(Conclusion) The effect of emergency surgery is good for patients with ruptured anterior circulation aneurysms(Hunt-Hess gradeⅠto Ⅳ).更多还原