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动脉瘤破裂引起蛛网膜下腔出血的基本治疗方法是闭塞动脉瘤颈,防止再出血,对此已无疑问。但是,对手术时机的选择,至今尚无统一的意见。为此,1981年到1984年进行了国际性颅内动脉瘤破裂后手术时机选择方面的协作研究。全世界共有68个研究中心参加了这次协作研究,日本有12名经验丰富的神经外科专家,27个相关的研究机构和指定的43名手术者参加。其研究对象是:①由囊状动脉瘤首次破裂所引起的蛛网膜下腔出血;②患者年龄在18岁以上;③蛛网膜下腔出血经腰穿、CT 扫描或手术确诊;④动脉瘤经尸检或动脉造影所证实;⑤出血后当日(Day-0)到第三天(Day-3)入院者。对手术后转归的评价,于术后6个月时由未参加手术的第三者(多为神经内科医生)担任。在这次国际性协作研究中,日本的病例数为1131例,约占全体病例(参加研究的各国病例总数)的1/3。患者背景与参加研究的其他国家相比无大的差别。研究结果表明,在日本,小型动脉瘤(直径少于12mm)占88.5%。虽然国内12个研究中心的患者状态、手术时期及手术效果都有很大不同,但从整体
Aneurysm rupture caused by subarachnoid hemorrhage basic treatment is occlusion aneurysm neck, to prevent rebleeding, which no doubt. However, there is no unified opinion on the timing of surgery. To this end, from 1981 to 1984 conducted a collaborative study on the timing of surgery after the international intracranial aneurysm rupture. A total of 68 research centers worldwide participated in the collaborative study, with 12 experienced neurosurgical specialists, 27 related research institutes and 43 designated surgeons in Japan. The research objects are: ① the first ruptured cystic aneurysm caused by subarachnoid hemorrhage; ② patients aged 18 years of age or above; ③ subarachnoid hemorrhage by lumbar puncture, CT scan or surgery confirmed; ④ aneurysm Autopsy or angiography confirmed; ⑤ bleeding after the day (Day-0) to the third day (Day-3) admission. The outcome of the surgery was evaluated at 6 months after surgery by a third party who did not participate in surgery (mostly neurologist). In this international collaborative study, the number of cases in Japan was 1,131, accounting for about one-third of all cases (the total number of countries participating in the study). The patient background is not much different from that of other countries participating in the study. The results show that in Japan, small aneurysms (less than 12 mm in diameter) accounted for 88.5%. Although the 12 state-of-the-art research centers in China have different patient status, operation time and operation effect,