中华实验外科杂志
中華實驗外科雜誌
중화실험외과잡지
CHINESE JOURNAL OF EXPERIMENTAL SURGERY
2014年
9期
2039-2041
,共3页
大脑中动脉M1段动脉瘤%显微手术夹闭%脑内血肿%临床预后
大腦中動脈M1段動脈瘤%顯微手術夾閉%腦內血腫%臨床預後
대뇌중동맥M1단동맥류%현미수술협폐%뇌내혈종%림상예후
M 1 segment of middle cerebral artery aneurysm%Microsurgery clipping operation%Intracerebral hematoma%Prognosis
目的 探讨大脑中动脉M1段动脉瘤临床特点及影响其手术预后的重要因素.方法 分析我院2009年1月至2013年12月收治的49例M1段动脉瘤患者,总结影像学资料、治疗和术后并发症等情况,探讨性别、年龄、入院时Hunt-Hess(H-H)评分、术前脑内血肿和M1段动脉瘤解剖位置对手术治疗后患者预后的影响.结果 翼点开颅动脉瘤夹闭术后,预后良好的患者为34例(69.38％).其中术前H-H评分为0～Ⅱ及Ⅲ～Ⅳ的患者预后好的比例分别为75.8％和56.3％,两者差异有统计学意义(P＜0.05);脑内无血肿患者临床预后好的比例为79.4％,明显的高于存在脑内血肿患者,两者差异有统计学意义(P＜0.05);M1段动脉瘤上壁型和下壁型的术后恢复好的比例分别为62.1％和80.0％,两者差异有统计学意义(P＜0.05).而性别和年龄对手术治疗后手术预后的影响差异无统计学意义(P＞0.05).结论 入院时的临床状态、动脉瘤的位置及脑内血肿的有无是影响M1段动脉瘤患者手术临床预后的重要因素,在手术前应对这3个方面的指标进行重点监测.
目的 探討大腦中動脈M1段動脈瘤臨床特點及影響其手術預後的重要因素.方法 分析我院2009年1月至2013年12月收治的49例M1段動脈瘤患者,總結影像學資料、治療和術後併髮癥等情況,探討性彆、年齡、入院時Hunt-Hess(H-H)評分、術前腦內血腫和M1段動脈瘤解剖位置對手術治療後患者預後的影響.結果 翼點開顱動脈瘤夾閉術後,預後良好的患者為34例(69.38％).其中術前H-H評分為0～Ⅱ及Ⅲ～Ⅳ的患者預後好的比例分彆為75.8％和56.3％,兩者差異有統計學意義(P＜0.05);腦內無血腫患者臨床預後好的比例為79.4％,明顯的高于存在腦內血腫患者,兩者差異有統計學意義(P＜0.05);M1段動脈瘤上壁型和下壁型的術後恢複好的比例分彆為62.1％和80.0％,兩者差異有統計學意義(P＜0.05).而性彆和年齡對手術治療後手術預後的影響差異無統計學意義(P＞0.05).結論 入院時的臨床狀態、動脈瘤的位置及腦內血腫的有無是影響M1段動脈瘤患者手術臨床預後的重要因素,在手術前應對這3箇方麵的指標進行重點鑑測.
목적 탐토대뇌중동맥M1단동맥류림상특점급영향기수술예후적중요인소.방법 분석아원2009년1월지2013년12월수치적49례M1단동맥류환자,총결영상학자료、치료화술후병발증등정황,탐토성별、년령、입원시Hunt-Hess(H-H)평분、술전뇌내혈종화M1단동맥류해부위치대수술치료후환자예후적영향.결과 익점개로동맥류협폐술후,예후량호적환자위34례(69.38％).기중술전H-H평분위0～Ⅱ급Ⅲ～Ⅳ적환자예후호적비례분별위75.8％화56.3％,량자차이유통계학의의(P＜0.05);뇌내무혈종환자림상예후호적비례위79.4％,명현적고우존재뇌내혈종환자,량자차이유통계학의의(P＜0.05);M1단동맥류상벽형화하벽형적술후회복호적비례분별위62.1％화80.0％,량자차이유통계학의의(P＜0.05).이성별화년령대수술치료후수술예후적영향차이무통계학의의(P＞0.05).결론 입원시적림상상태、동맥류적위치급뇌내혈종적유무시영향M1단동맥류환자수술림상예후적중요인소,재수술전응대저3개방면적지표진행중점감측.
Objective To analyze the effect of middle cerebral artery (MCA) the initial part of the aneurysm (M1) operation prognosis factors.Methods A retrospective analysis of our hospital in 2009.1-2013.12 treated 49 cases of M1 patients with aneurysms,summarize the imaging data,treatment and postoperative complications of different gender,age,admission Hunt-Hess (H-H) score,preoperative cerebral hematoma with no and M1 aneurysm of cutting position on the operation treatment prognosis.Results After wings point craniotomy aneurysm surgery,patients with good prognosis was 34 (69.38％).H-H preoperative score was 0-Ⅱ and Ⅲ-Ⅳ scores for patient prognosis good rates were 75.8％ and 56.3％,the difference was statistically significant (P ＜ 0.05) ; the good ratio of patients with non-intracerebral hematoma was 79.4％,which significantly higher than in patients with intracerebral hematoma exists,the difference was statistically significant (P ＜ 0.05) ; After the wall type and wall type of recovery under good rates were 62.1％ and 80.0％,the difference was statistically significant (P ＜ 0.05).Gender and age there is no statistically significant difference in the impact of surgery on the prognosis after surgery (P ＞ 0.05).Conclusion Patients with M1 aneurysm,clinical condition and intracerebral hematoma admission has no is an important factor affecting the prognosis of operation,gender and age is not.Operation complications mainly associated with aneurysmal location,for patients with upper wall aneurysm,lenticulostriate artery and its branches is essential to protect.In addition,perfect preoperative angiography,intraoperative gently pull and careful examination of small vessel branch covert operation is the key to success.
