CAJ | 학술논문

目的：探讨颅内动脉瘤破裂出血并脑积水的治疗方案和疗效，为其临床治疗的选择提供依据。方法对40例合并脑积水的颅内动脉瘤患者（ Hunt-Hess分级在Ⅱ-Ⅳ级）进行回顾性分析，比较单纯动脉瘤夹闭术（非分流组）和一期行动脉瘤夹闭及脑室心房分流术（分流组）治疗的效果。其中分流组18例，非分流组22例，对2组患者进行日常生活能力GOS分级评价，比较2组的疗效、预后良好率。结果①分流组的疗效优于非分流组，差异有统计学意义（P＜0．05）；②分流组预后良好率明显高于非分流组，差异有统计学意义（P＜0．05）。结论颅内动脉瘤破裂出血并脑积水的患者在动脉瘤夹闭的同时行脑室心房分流术，其预后明显优于单纯行动脉瘤夹闭而未行脑室心房分流的患者；对合并脑积水的动脉瘤患者，在夹闭动脉瘤的同时行脑室心房分流术，对改善动脉瘤患者的预后有重要临床价值。
목적：탐토로내동맥류파렬출혈병뇌적수적치료방안화료효，위기림상치료적선택제공의거。방법대40례합병뇌적수적로내동맥류환자（ Hunt-Hess분급재Ⅱ-Ⅳ급）진행회고성분석，비교단순동맥류협폐술（비분류조）화일기행동맥류협폐급뇌실심방분류술（분류조）치료적효과。기중분류조18례，비분류조22례，대2조환자진행일상생활능력GOS분급평개，비교2조적료효、예후량호솔。결과①분류조적료효우우비분류조，차이유통계학의의（P＜0．05）；②분류조예후량호솔명현고우비분류조，차이유통계학의의（P＜0．05）。결론로내동맥류파렬출혈병뇌적수적환자재동맥류협폐적동시행뇌실심방분류술，기예후명현우우단순행동맥류협폐이미행뇌실심방분류적환자；대합병뇌적수적동맥류환자，재협폐동맥류적동시행뇌실심방분류술，대개선동맥류환자적예후유중요림상개치。
0bjective To investigate the treatment program and therapeutic effects of patients with intracranial aneurysms complicating hydrocephalus ,in order to provide basis for clinical treatment .Methods Through the retrospective analysis of 40 patients with intracranial aneurysms of poor grade ( Hunt-Hess grade Ⅱ -Vgrade),to compare whether there were differences of the effects between simple aneurysm surgery(shunt group)and ventricle-atrium shunt with aneurysm surgery(non-shunt group) at the same time.18 patients in the shunt group and other 22 patients in the non -shunt group.Through the evaluation of daily living ability with GOS grade,the efficacy and prognosis of two groups were compared with testing statistical analysis .Results Curative effect and prognosis of the shunt group was better than the non-shunt group,which showed a significant difference(P<0.05).Conclusion It indicates that ventricle -atrium shunt with aneurysm surgery is superior to sample aneurysm surgery for the patients with intracranial aneurysms complicating hydrocephalus ,so treatment of ventricle-atrium shunt with aneurysm surgery has significant clinical value in modifying prognosis.