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目的探讨急性期动脉瘤实施夹闭手术对提高生存质量与降低致残率的影响。方法对 43例颅内动脉瘤施行急性期显微神经外科动脉瘤夹闭术。结果死亡 4例 ,死因分别为肺感染、脑血管痉挛、多发动脉瘤未能完全夹闭再出血 ,2例致残 ,37例恢复良好。结论动脉瘤破裂出血如有条件应尽可能行急性期动脉瘤夹闭术。但应注意 :①有效降低颅内压利于显露 ;②急性期手术术中易发生动脉瘤破裂 ,应充分解剖蛛网膜 ,暴露出血点 ,夹闭动脉瘤 ;③术后持续蛛网膜下腔灌洗 ,可有效降低脑血管痉挛及脑积水发病率
Objective To investigate the effect of occlusion surgery on the quality of life and the morbidity of disability caused by acute aneurysm. Methods Forty - three patients with intracranial aneurysm underwent acute microsurgical aneurysm clipping. The results of death in 4 cases, the cause of death were pulmonary infection, cerebral vasospasm, multiple aneurysms failed to completely clipped rebleeding, 2 cases of disability, 37 cases recovered well. Conclusion Aneurysm rupture bleeding should be performed if possible. Acute aneurysm clipping. But should pay attention to: ① reduce intracranial pressure conducive to reveal; ② acute surgical rupture of aneurysm prone surgery, the arachnoid should be fully dissected, bleeding points were exposed, aneurysm clipping; ③ continuous subarachnoid lavage , Can effectively reduce the incidence of cerebral vasospasm and hydrocephalus