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目的总结显微手术夹闭破裂颅内动脉瘤后脑血管痉挛的防治经验及体会。方法48例破裂颅内动脉瘤患者,行颅内动脉瘤夹闭术,术中采用罂粟碱溶液冲洗,术后采取腰大池持续引流、尼莫地平经深静脉持续泵入、适度的3H治疗等综合措施。结果48例患者,术后6例(12.5%)发生脑血管痉挛;术后随访3个月,根据GOS评分,恢复良好34例(70.8%),轻残11例(22.9%),重残3例(6.3%),无植物生存和死亡病例。结论破裂颅内动脉瘤显微夹闭术中、术后,积极预防和治疗脑血管痉挛可显著降低患者的致残率和病死率。
Objective To summarize the experience of prevention and treatment of cerebral vasospasm after microsurgical clipping of ruptured intracranial aneurysms. Methods Forty-eight patients with ruptured intracranial aneurysm were treated with clipping of intracranial aneurysm. The patients were treated with papaverine solution during operation. The patients were continuously drained by the lumbar cistern. Nimodipine was continuously pumped through the deep vein for moderate 3H treatment Comprehensive measures. Results According to the GOS score, 34 patients (70.8%) were recovered well, 11 (22.9%) had mild disability, and 3 were severely disabled (3) after 48 months. Six patients (12.5%) developed cerebral vasospasm after operation. Cases (6.3%), no cases of plant survival and death. Conclusion In the treatment of ruptured intracranial aneurysm, the prevention and treatment of cerebral vasospasm can significantly reduce the morbidity and mortality of patients during and after microsurgery.