CAJ | 학술논문

目的总结颅内动脉瘤破裂合并脑内血肿的临床治疗经验.方法回顾性分析焦作市人民医院神经外科一区自2009年5月至2013年9月收治的23例行急诊手术治疗的颅内动脉瘤破裂合并脑内血肿患者的临床资料.17例患者术前行头颅CTA检查,6例患者术前仅行头颅CT检查.23例均于入院24h内行急诊开颅手术,均采用扩大翼点入路,直视下夹闭动脉瘤并清除脑内血肿.结果根据格拉斯哥预后评分(GOS),出院时恢复良好4例,轻残6例,重残8例,死亡5例.术后15例获得随访,平均随访3.3年,均无再出血发生;8例复查CTA,7例完全夹闭,1例瘤颈少许残余.结论 CTA为颅内动脉瘤破裂合并脑内血肿的首选检查手段;急诊手术可提高颅内动脉瘤合并脑内血肿患者的生存率,改善预后.
목적 총결로내동맥류파렬합병뇌내혈종적림상치료경험.방법 회고성분석초작시인민의원신경외과일구자2009년5월지2013년9월수치적23례행급진수술치료적로내동맥류파렬합병뇌내혈종환자적림상자료.17례환자술전행두로CTA검사,6례환자술전부행두로CT검사.23례균우입원24h내행급진개로수술,균채용확대익점입로,직시하협폐동맥류병청제뇌내혈종.결과 근거격랍사가예후평분(GOS),출원시회복량호4례,경잔6례,중잔8례,사망5례.술후15례획득수방,평균수방3.3년,균무재출혈발생;8례복사CTA,7례완전협폐,1례류경소허잔여.결론 CTA위로내동맥류파렬합병뇌내혈종적수선검사수단;급진수술가제고로내동맥류합병뇌내혈종환자적생존솔,개선예후.
Objective To evaluate the diagnosis and emergency surgical treatment of ruptured intracerebral aneurysms (RIAs) accompanied with intracerebral hematomas (ICH).Methods A retrospective study was performed on the clinical data of 23 patients ofICH following RIAs,admitted to our hospital from May 2009 to September 2013.CTA was performed in 17 patients and cranial CT in 6 before the operation.The emergent operations were performed in all the patients within 24 hours of aneurysm rupture; pterion approach was adopted to clip the arterial aneurysm and clear intracerebral hematoma.Results According to Glasgow outcome scale (GOS) scores,4 recovered well,6 were mildly disabled,8 were severely disabled and 5 died.After follow-up for 3.3 years in 15 patients,no further bleeding occurred.Eight aneurysms were re-checked by CTA,7 aneurysms were completely clipped and 1 aneurysm had residual neck.Conclusions Preoperative CTA is essential for the correct diagnosis of ICHs due to RIA.The curative effect of the emergent operation can improve the survival rate and prognosis of patients with RIA accompanied with ICH.