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目的:旨在进一步提高手术治疗破裂的前循环脑动脉瘤的效果。方法:回顾性分析显微手术治疗的56例破裂前循环脑动脉瘤患者的临床资料。结果:56例病人,共61个脑动脉瘤,其中45枚行动脉瘤颈夹闭,6枚夹闭瘤颈后切除瘤体,另10枚动脉瘤予以瘤壁包裹加固术。术后第3天发生血管闭塞1例,遗留肢体偏瘫。25例随访1个月～5年,恢复良好17例,中残或重残2例,死亡2例。结论:显微手术治疗破裂的脑动脉瘤,不仅有效地防止再出血,而且有利于脑血管痉挛的防治。术后扩充血容量,提升血压,扩张血管对防治脑血管痉挛具有相当好的疗效。
Objective: To further improve the surgical treatment of ruptured anterior circulation cerebral aneurysm effect. Methods: The clinical data of 56 patients with ruptured anterior cerebral artery aneurysm treated by microsurgery were analyzed retrospectively. Results: Fifty-six patients had 61 cerebral aneurysms, of which 45 had aneurysm neck clipping, 6 had clipping neck and resected the tumor, and the other 10 aneurysms were treated with wall wrapping reinforcement. One case of vascular occlusion occurred on the third day after operation, and left limb hemiplegia. Twenty-five patients were followed up for 1 month to 5 years, 17 cases recovered well, 2 cases were moderate or severe disability, and 2 died. Conclusion: Microsurgical treatment of ruptured cerebral aneurysms not only prevent rebleeding effectively, but also help to prevent and treat cerebral vasospasm. Postoperative expansion of blood volume, increase blood pressure, dilation of blood vessels on the prevention and treatment of cerebral vasospasm has a very good effect.