王琳玺 廉庆北 徐善才 史怀璋.动脉瘤性蛛网膜下腔出血的治疗进展与探讨[J].,2015,15(13):2540-2542 |
动脉瘤性蛛网膜下腔出血的治疗进展与探讨 |
Progress and Discussion of High-grade Aneurysmal SubarachnoidHemorrhage Treatment |
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DOI: |
中文关键词: 高分级 蛛网膜下腔出血 颅内动脉瘤 |
英文关键词: Poor-grade Subarachnoid hemorrhage Intracranial aneurysm |
基金项目:黑龙江省卫生厅科研基金项目(WSJ20122-016) |
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中文摘要: |
颅内动脉瘤破裂导致的自发性蛛网膜下腔出血是一种致残率以及病死率都非常高的一种疾病,其中动脉瘤性蛛网膜下腔
出血Hunt-Hess 和世界神经外科医师联盟Ⅳ、V级的患者为高分级颅内动脉瘤性蛛网膜下腔出血,这部分患者,无论采取何种治
疗方案,预后仍较差。目前对高分级动脉瘤性蛛网膜下腔出血的治疗仍处于探索阶段,并没有形成统一的临床治疗指导规范或临
床路径,其中是在采取保守治疗或者手术治疗的问题上存在较大争议,而在选择手术治疗时又存在手术时机的问题,并且随着显
微颅内动脉瘤夹闭术的成熟以及颅内动脉瘤的血管内治疗材料和技术的迅速发展及治疗经验的积累,对于患者采取何种手术方
式已成为近年来的争议热点,所以如何对这部分患者实施积极有效的治疗而改善其预后,已成为目前神经外科医生必须要解决
的焦点问题。 |
英文摘要: |
Subarachnoid hemorrhage due to rupture of intracranial aneurysmis a disease of high morbidity and mortality. Ⅳ and
V grades of Hunt-Hess and World Federation of Neurosurgical Societies (WFNS) are high-grade aneurysmal subarachnoid hemorrhage.
The prognosis of patients suffered by these two grades aneurysmal subarachnoid hemorrhage is very poor even if many treatments have
been used. However, the treatment of poor-grade arterial aneurysmal subarachnoid hemorrhage is still at the exploratory stage. There is
no uniform clinical treatment guidelines or clinical pathways. Currently, there is considerable controversy between the conservative treatment
and surgical treatment, and the choice of surgical treatment time is also a tricky problem. Recently, with the mature of microscopic
intracranial aneurysm clipped operation, rapid development of intracranial aneurysm endovascular treatment materials and technology
and the experience accumulation of treatment, which way for the patients to take surgery has become a hot controversy. Therefore, how
to implement positive and effective treatment to this part of patients and improve the prognosis must become the focus problem for the
neurosurgeon in the future. |
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