Surgical Clipping for Ruptured Cerebral Anterior Circulating Aneurysm_West China Medical Journal

Authors：

ZENG Qiangjun , YANG Qing , ZHOU Mingsen , GAN Linyuan

Department of Neurosurgery, the Second People’s Hospital of Dazhou City, Dazhou, Sichuan 635000, P.R.China;

Corresponding?author：

Keywords：

顱內動脈瘤; 破裂; 前循環; 夾閉術

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【摘要】目的探討開顱手術夾閉顱內前循環動脈瘤破裂的方法和療效。方法回顧分析2005年1月-2008年1月28例前循環動脈瘤破裂的早期外科手術治療情況。分析其臨床表現、手術入路和預后，用格拉斯哥術后評分量表對術后患者神經功能評分。結果 28例患者共30個動脈瘤，手術成功夾閉28個，包裹2個。術后3個月內，患者恢復良好15例（53.57%），中度病殘7例（25.00%），重度病殘5例（17.86%），死亡1例（3.57%）。結論早期開顱手術夾閉動脈瘤能減少再出血率和術前死亡率，術后預后較好，是治療前循環動脈瘤破裂較為理想的方法。
【Abstract】 Objective To investigate the clinical strategy and effect of early phase surgery for ruptured cerebral anterior circulating aneurysm. Methods A retrospective analysis was done for 28 patients with ruptured anterior circulating aneurysms who underwent early phase (within 3 days) surgical clipping from January 2005 to January 2008. Their manifestations, surgical approach, and outcomes were analyzed. Glasgow outcome scale (GOS) was used to evaluate patients’ neurological function after operation. Results Among 30 intracranial aneurysms in 28 patients, 28 aneurysms were clipped successfully, and the other 2 were wrapped. One patient (3.57%) died after surgery. The follow-up data showed an excellent outcome was achieved in 15 cases, mild disability in 7 cases, and severe disability in 5 cases. Conclusion Early phase surgical clipping for ruptured cerebral anterior circulating aneurysm can reduce the chance of reruputure of aneurysms and the mortality in preoperative phase with good outcomes. The early phase surgical clipping the aneurysms is considered the feasible opinion.

Citation： ZENG Qiangjun,YANG Qing,ZHOU Mingsen,GAN Linyuan. Surgical Clipping for Ruptured Cerebral Anterior Circulating Aneurysm. West China Medical Journal, 2010, 25(7): 1276-1278. doi: Copy

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1. 王忠誠. 神經外科學[M]. 武漢: 湖北科學技術出版社, 1998: 599-601.
2. 顧宇翔, 毛穎, 宋冬雷, 等. 腦前循環動脈瘤破裂早中期的顯微外科手術治療[J]. 中華外科雜志, 2006, 44(6): 412-415.
3. 楊立莊, 葉偉, 王社軍. 破裂腦動脈瘤早期手術中破裂的探討[J]. 中華神經外科雜志, 2001, 17(6): 387-388.
4. 李進, 游潮, 賀民, 等. 大腦中動脈動脈瘤伴腦內血腫的顯微手術治療(附15例分析)[J]. 中國微侵襲神經外科雜志, 2008, 13(7): 304-306.
5. Goddard AJ, Raju PP, Gholkar A. Does the method of treatment of acutely ruptured intracranial aneurysms influence the incidence and duration of cerebral vasospasm and clinical outcome[J]. J Neurol Neurosurg Psychiatry, 2004, 75(6): 868-872.
6. 傅傳徑, 高覺民, 李善泉. 前循環破裂動脈瘤的急診手術處理[J]. 中國腦血管病雜志, 2006, 3(10): 437-439.
7. Molyneux A, Kerr R, Stratton I, et al. International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial[J]. Lancet, 2002, 360(9342): 1267-1274.

West China Medical Journal

Surgical Clipping for Ruptured Cerebral Anterior Circulating Aneurysm

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