王政

[摘要] 目的 研究讨论早期显微手术夹闭瘤颈治疗脑动脉瘤破裂出血的临床治疗效果。 方法 选择2014年1月～2017年1月于我院行手术治疗的脑动脉瘤破裂出血患者60例，其中于患者破裂出血72h内进行手术的患者35例，作为早期组，破裂出血超过72h进行手术的患者25例，作为择期组，对两组患者均给予显微手术夹闭瘤颈治疗，观察两组患者的手术情况、住院时间、治疗效果以及并发症情况。 结果 本研究显示，两组患者手术时间、术中出血量、住院时间等临床手术指标数值差异无统计学意义（P>0.05）；A组患者格拉斯哥预后评分良好率为85.7%，显著高于B组的56.0%（P<0.05）；两组的死亡率比较差异无统计学意义（P>0.05）；两组患者治疗后均出现少量并发症（均为动脉瘤再破裂），發生例率分别为2（5.7）、2（8.0），差异无统计学意义（P>0.05）。 结论 早期显微手术夹闭瘤颈可显著改善对脑动脉瘤破裂出血患者的预后效果，提高患者的生活质量，值得临床大力推广。

[关键词] 脑动脉瘤破裂出血；显微手术；瘤颈夹闭

[中图分类号] R651.12 [文献标识码] A [文章编号] 2095-0616（2017）16-204-03

Early microsurgical clipping of the neck in treatment of cerebral aneurysm rupture bleeding

WANG Zheng

Maoming Hospital of Traditional Chinese Medicine，Maoming 525000，China

[Abstract] Objective To explore the clinical effect of early microsurgical clipping of the neck in treatment of cerebral aneurysm rupture bleeding. Methods 60 patients with ruptured intracranial aneurysms with surgical treatment in our hospital from January 2014 to January 2017 were selected.35 patients underwent surgical treatment of 72h in patients with rupture and bleeding were as early group，25 patients underwent surgical treatment more than 72h in patients with rupture and bleeding were as elective group.All the patients in the two groups were treated with microsurgical clipping of the neck.Operation time，hospitalization time，therapeutic effect and complications of the two groups were observed. Results The difference of operation time，intraoperative blood loss，length of stay and other clinical indicators of the two groups was slight（P>0.05）.The Glasgow score of the prognosis of patients in group A was 85.7%， which was significantly higher than that in group B with 56.0%（P<0.05）.The difference in mortality between the two groups was slight（P>0.05）.After treatment，there were a small number of complications （aneurysm rupture again）， the occurrence rate were 2（5.7），2（8.0），the difference was slight（P<0.05），it is not statistically significant. Conclusion Early microsurgical clipping of the neck can significantly improve the prognosis of patients with cerebral aneurysm rupture bleeding，and improve the quality of life of patients.It is worthy of clinical promotion.

[Key words] Cerebral aneurysm rupture bleeding；Microsurgery；Neck clipping

脑动脉瘤作为临床上常见的一种危重病症[1-2]，其将有可能会致使患者机体神经功能受到损伤甚至是死亡[3]，具有极高的致残率和致死率。而若是脑动脉瘤破裂出血并未能得到及时有效的抢救，患者出现再次破裂出血的几率将会增大到30%～50%[4]，且随着而来的致死率也会增高[5]。近几年，随着显微技术的飞速发展，显微神经外科逐渐发展成为一项重要医学类型，在临床上，显微手术夹闭瘤颈为脑动脉瘤的主要治疗方式，但临床上对于手术的时机的研究尚少，本研究选择我院2014年1月～2017年1月收治行手术治疗的脑动脉瘤破裂出血患者60例作为研究对象，讨论早期显微手术夹闭瘤颈治疗脑动脉瘤破裂出血的临床治疗效果。end……