韦树德等

【摘要】目的探析脑动脉瘤破裂应用早期显微手术治疗的临床效果。

方法选取2011年1月至2013年12月脑动脉瘤破裂患者50例，按治疗方式的不同分为两组， 观察组25例行早期显微手术疗法，对照组25例行常规手术疗法，比较两组患者的临床效果、临床各项指标及术后并发症发生情况。

结果观察组、对照组的临床总有效率分别为92.0%、60.0%，组间差异有统计学意义（P<001）； 观察组的术中出血量、住院时间、神志恢复时间等各项临床指标显著少于对照组（P<0001）； 观察组、对照组的并发症发生率分别为8.0%、32.0%，组间差异有统计学意义（P<005）。

结论 脑动脉瘤破裂早期行显微手术治疗临床效果确切，可促进患者病情迅速康复，微创度高，安全可靠，值得临床推广。

【关键词】显微镜手术；脑动脉瘤破裂；脑前循环系统

中图分类号：R739.41文献标识码：ADOI：10.3969/j.issn.10031383.2014.05.020

【Abstract】ObjectiveTo explore and analyze the clinical effect of early microsurgery in the treatment of ruptured cerebral aneurysm.

Methods50 cases of patients with ruptured cerebral aneurysm from January，2011 to December，2013 were selected and divided into observation group and control group according to different treatment methods.The observation group underwent early microsurgery，while the control group was given regular surgical treatment.Then，clinical effects，various clinical indicators and postoperative complications of two groups were observed and compared.

Results The total effective rate of the observation group and the control group were 92.0% and 60.0% respectively，so their difference was statistically significant（P<001）.Various clinical indicators included intraoperatve blood loss，hospital stay and consciousness recovery time of the observation group were significantly less than those of the control group（P<0001）.Incidence rate of complications of the observation group and the control group were 8.0% and 32.0% respectively，so their difference was statistically significant（P<005）.

ConclusionEarly microsurgical treatment for patients with ruptured cerebral aneurysm has exact effect in improving the recovery of patients.It features high minimal invasion，security，and reliability，which makes it worthy of promotion in clinic.

【Key words】microsurgery；ruptured cerebral aneurysm；forebrain circulatory system

颅内动脉瘤是指脑动脉内腔的局限性异常扩大造成动脉壁的一种瘤状突出，多因脑动脉管壁局部的先天性缺陷和腔内压力增高的基础上引起囊性膨出，是造成蛛网膜下腔出血（SAH）的首位病因[1]。其中腔内压力增高引起的动脉瘤占脑动脉瘤的70%～80%。脑动脉瘤破裂出血如得不到及时、规范的治疗，将严重影响患者的生命健康及质量，而肢体抽搐、喷射性剧吐、头痛是该病发病的危险信号。有研究认为，脑动脉瘤破裂患者早期进行显微手术疗法，可促进患者病情迅速康复，临床效果确切[2]。探析脑动脉瘤破裂的最佳治疗方案具有重要的临床意义，我院2011年1月至2013年12月对脑动脉瘤破裂患者进行早期显微手术治疗，效果满意，现报道如下。……