早期开颅手术夹闭颅内前循环动脉瘤

【】目的探讨开颅手术夹闭颅内前循环动脉瘤破裂的方法和疗效。方法回顾分析2005年1月-2008年1月28例前循环动脉瘤破裂的早期外科手术治疗情况。分析其临床表现、手术入路和预后，用格拉斯哥术后评分量表对术后患者神经功能评分。结果28例患者共30个动脉瘤，手术成功夹闭28个，包裹2个。术后3个月内，患者恢复良好15例（53.57%），中度病残7例（25.00%），重度病残5例（17.86%），死亡1例（3.57%）。结论早期开颅手术夹闭动脉瘤能减少再出血率和术前死亡率，术后预后较好，是治疗前循环动脉瘤破裂较为理想的方法。【Abstract】ObjectiveToinvestigatetheclinicalstrategyandeffectofearlyphasesurgeryforrupturedcerebralanteriorcirculatinganeurysm.MethodsAretrospectiveanalysiswasdonefor28patientswithrupturedanteriorcirculatinganeurysmswhounderwentearlyphase(within3days)surgicalclippingfromJanuary2005toJanuary2008.Theirmanifestations,surgicalapproach,andoutcomeswereanalyzed.Glasgowoutcomescale(GOS)wasusedtoevaluatepatients’neurologicalfunctionafteroperation.ResultsAmong30intracranialaneurysmsin28patients,28aneurysmswereclippedsuccessfully,andtheother2werewrapped.Onepatient(3.57%)diedaftersurgery.Thefollow-updatashowedanexcellentoutcomewasachievedin15cases,milddisabilityin7cases,andseveredisabilityin5cases.ConclusionEarlyphasesurgicalclippingforrupturedcerebralanteriorcirculatinganeurysmcanreducethechanceofreruputureofaneurysmsandthemortalityinpreoperativephasewithgoodoutcomes.Theearlyphasesurgicalclippingtheaneurysmsisconsideredthefeasibleopinion.？