CAJ | 학술논문

[目的]探讨颅内动脉瘤破裂出血 Hunt-Hess Ⅳ级患者早期手术效果及指征。[方法]回顾性分析41例术前 Hunt-Hess Ⅳ级颅内动脉瘤患者早期行开颅动脉瘤夹闭术并去骨瓣减压手术效果。[结果]12例前交通动脉瘤及16例后交通动脉瘤总体治疗效果差；前者5例死亡，后者6例死亡。13例大脑中动脉瘤总体治疗效果良好。[结论]对颅内动脉瘤患者要个体化分析病情，血肿占位效应和出血后脑损伤、脑缺血和脑梗死共同损害的严重程度决定 Hunt-Hess 分级的高低，并决定手术与否及手术效果。
[목적]탐토로내동맥류파렬출혈 Hunt-Hess Ⅳ급환자조기수술효과급지정。[방법]회고성분석41례술전 Hunt-Hess Ⅳ급로내동맥류환자조기행개로동맥류협폐술병거골판감압수술효과。[결과]12례전교통동맥류급16례후교통동맥류총체치료효과차；전자5례사망，후자6례사망。13례대뇌중동맥류총체치료효과량호。[결론]대로내동맥류환자요개체화분석병정，혈종점위효응화출혈후뇌손상、뇌결혈화뇌경사공동손해적엄중정도결정 Hunt-Hess 분급적고저，병결정수술여부급수술효과。
[Objective]To explore the efficacy and indications of early surgery for ruptured intracranial an-eurysm with Hunt-Hess grade Ⅳ.[Methods]Clinical data of 41 patients with intracranial aneurysms of preop-erative hunt-hess grade Ⅳ undergoing early craniotomy,aneurismal clipping and decompressive craniectomy were analyzed retrospectively.[Results]The overall treatment effect of 12 patients with anterior communica-ting aneurysms and 16 patients with posterior communicating aneurysms was poor.Five patients with anterior communicating aneurysms and six patients with posterior communicating aneurysms died.The overall treat-ment effect of 13 patients with middle cerebral artery aneurysms was good.[Conclusion]The conditions of pa-tients with intracranial aneurysms should be analyzed individually.High grade of Hunt-Hess is caused by the occupying effect of hematoma and brain injury after hemorrhage together with cerebral ischemia and infarction. All of them have important influence on the prognosis of surgery,and decide the operation or not.