CAJ | 학술논문

目的探讨老年颅内破裂动脉瘤患者施行开颅夹闭手术的治疗效果. 方法根据CT及CTA图像经翼点入路,选择适当的位置和角度对75例颅内动脉瘤破裂患者动脉瘤进行夹闭,观察手术疗效及术后并发症,采用格拉斯哥预后量表(GOS)对预后情况进行评定. 结果 75例患者中共有动脉瘤77个,夹闭76个；术后并发症主要为颅内血肿5例,肺部感染4例,电解质紊乱10例,颅内感染2例,心律失常3例,消化道出血5例,脑梗死3例；根据GOS对预后进行评估,治愈者48例(64.0％),轻度残障者1 6例(21.3％),重度残障者6例(8.0％),植物生存者2例(2.7％),死亡3例(4.0％),治愈率64.0％,总体预后良好率为85.3％. 结论使用开颅夹闭的方法对高龄颅内破裂动脉瘤进行治疗,手术疗效好,治愈率高.
목적 탐토노년로내파렬동맥류환자시행개로협폐수술적치료효과. 방법 근거CT급CTA도상경익점입로,선택괄당적위치화각도대75례로내동맥류파렬환자동맥류진행협폐,관찰수술료효급술후병발증,채용격랍사가예후량표(GOS)대예후정황진행평정. 결과 75례환자중공유동맥류77개,협폐76개；술후병발증주요위로내혈종5례,폐부감염4례,전해질문란10례,로내감염2례,심률실상3례,소화도출혈5례,뇌경사3례；근거GOS대예후진행평고,치유자48례(64.0％),경도잔장자1 6례(21.3％),중도잔장자6례(8.0％),식물생존자2례(2.7％),사망3례(4.0％),치유솔64.0％,총체예후량호솔위85.3％. 결론 사용개로협폐적방법대고령로내파렬동맥류진행치료,수술료효호,치유솔고.
Objective To explore the efficacy of craniotomy and aneurysm clipping in elderly patients with ruptured intracranial aneurysms.Methods Totally 75 elderly patients with ruptured intracranial aneurysms in our hospital who underwent craniotomy and intracranial aneurysm clipping:approaching into head by wing point based on CT image,selecting the appropriate position and angle for clipping the aneurysm.Surgical efficacy and postoperative complications were observed.Prognosis was assessed by Glasgow Outcome Scale (GOS).Results 77 aneurysms presented in 75 patients and 76 aneurysms were clipped.The main postoperative complications were intracranial hematoma (5 cases),pulmonary infection (4 cases),electrolyte imbalance (10 cases),intracranial infection (2 cases),arrhythmia (3 cases),gastrointestinal bleeding (5 cases),cerebral infarction (3 cases).GOS assessment demonstrated that prognosis in 48 cases was good (64.0％),16 cases was moderate disability (21.3％),6 cases was severe disability (8.0％),2 cases was vegetative survival (2.7％),3cases was in death (4.0％).The cure rate was 64.0％ and the overall good-prognosis rate was 85.3％.Conclusions Craniotomy and aneurysm clipping has a better surgical efficacy and a high cure rate in elderly patients with ruptured intracranial aneurysm.