CAJ | 학술논문

目的探讨神经介入联合显微神经外科手术治疗后循环动脉瘤破裂出血伴脑疝形成的临床疗效. 方法河北医科大学第一医院神经外科自2010年1月至2013年8月急诊综合治疗(早期侧脑室引流术、神经介入动脉瘤栓塞术及后颅窝减压术)11例后循环动脉瘤破裂出血伴脑疝形成患者,其中小脑后下动脉动脉瘤5例、大脑后动脉动脉瘤2例、基底动脉顶端动脉瘤3例、椎基底动脉移行处动脉瘤1例,采用改良Rankin分级量表(mRS)评分和Glasgow预后分级量表(GOS)评分评价患者的预后. 结果术后13d1例因并发肺部感染和应激性溃疡死亡,剩余患者出院后6个月随访显示5例恢复良好,3例植物生存,2例重残. 结论神经介入联合显微神经外科手术可以降低后循环动脉瘤破裂伴脑疝形成的死亡率及致残率.
목적 탐토신경개입연합현미신경외과수술치료후순배동맥류파렬출혈반뇌산형성적림상료효. 방법 하북의과대학제일의원신경외과자2010년1월지2013년8월급진종합치료(조기측뇌실인류술、신경개입동맥류전새술급후로와감압술)11례후순배동맥류파렬출혈반뇌산형성환자,기중소뇌후하동맥동맥류5례、대뇌후동맥동맥류2례、기저동맥정단동맥류3례、추기저동맥이행처동맥류1례,채용개량Rankin분급량표(mRS)평분화Glasgow예후분급량표(GOS)평분평개환자적예후. 결과 술후13d1례인병발폐부감염화응격성궤양사망,잉여환자출원후6개월수방현시5례회복량호,3례식물생존,2례중잔. 결론 신경개입연합현미신경외과수술가이강저후순배동맥류파렬반뇌산형성적사망솔급치잔솔.
Objective To investigate the therapeutic effects of endovascular interventional therapies combined with microneurosurgery on patients suffered from cerebral herniation induced by raptured posterior circulation aneurysms.Methods Eleven patients with cerebral hemiation induced by ruptured posterior circulation aneurysms,admitted to our hospital from January 2010 to August 2013,were chosen in our study; among them,five had aneurysms of posterior inferior cerebellar artery,two aneurysms of posterior cerebral artery,three aneurysms of basilar artery apexand and one aneurysm of vertebrobasila transitional.The prognosis was assessed by modified Rankin scale (mRS) and Glasgow outcome scale (GOS).Results During the period of hospitalization,1 patient dead of pulmonary infection and stress ulcer; six months of follow up showed that five patients got good improvement,three patients were living on the vegetative state and two patients were in severe disability.Conclusion The endovascular interventional treatment combined with microneurosurgery can reduce the mortality and disability of patients with cerebral hemiation induced by ruptured posterior circulation aneurysms.