【作者】 白召；

【导师】 许侃；

【作者基本信息】 吉林大学 ， 外科学， 2012， 硕士

【摘要】 目的：探讨CTA辅助下重症大脑中动脉瘤破裂后伴发侧裂血肿的外科治疗结果。方法：30例患者接受血肿清除术，同时行夹闭治疗、去骨瓣减压。对这种病例的治疗效果进行分析、总结结果：预后采用KPS评分判定，随访一年。30例中KPS评分，90-100分2例、60-80分8例、40-50分10例、10-30分6例、0分4例。Hunt-HessⅣ组中18例KPS评分：90-100分2例、60-80分6例、40-50分6例、10-30分4例。Hunt-HessⅤ组中12例KPS评分：60-80分2例、40-50分4例、10-30分2例、0分（死亡）4例。结论：对于Hunt-Hess分级Ⅳ及Ⅴ级的危重病例，积极的外科治疗可以获得较好的效果，早期手术是提高预后的关键，而头部CTA检查能在短时间内明确诊断，为治疗提供充分的影像依据。更多还原

【Abstract】 Abstract： Objective This study was conducted to investigate the result ofmicrosurgical treatment of poor-grade ruptured middle cerebral arteryaneurysms with intrasylvian hematomas assisted by CT angiography.Mehtods：Between Jun2008and Jun2010,30cases with poor-graderuptured middle cerebral artery aneurysms with intrasylvian hematomas weretreated under the assistance of CTA. All of the patients underwent microsugicalclipping aneurysms and decompressive craniotomy after evacuatingintrasylvian homotomas. Results of the treatment for these cases were analyzedto summarize the experience.Results: The prognoses were assessed according to Karnofskyperformance scale (KPS) and the clinical follow-up period is1year. In30cases:2were90-100scores of KPS,8was60-80scores of KPS,10was40-50scoresof KPS,6was10-30scores of KPS,4was0score of KPS. In group Ⅳ:2were90-100scores of KPS,6were60-80scores of KPS,6was40-50scores of KPS,4was10-30scores of KPS. In groupⅤ:2was60-80scores of KPS,4was40-50scores of KPS,2was10-30scores of KPS,4was0score of KPS.Conclusion: For ruptured middle cerebral artery aneurysms ofHunt-Hess grade Ⅳ and Ⅴ with intrasylvian hematomas. CT angiography canprovide adequate imaging information in a short time for the operation. werecommend immediate microsugical clipping aneurysms and decompressivecraniotomy after evacuating intrasylvian.更多还原