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1981～1989年作者收治破裂脑动脉瘤患者482例,其中,发病一周内手术240例。作者以此为研究对象,分析早期手术后脑血管痉挛与予后的关系。年龄19～74岁,平均51.9岁。男10例,女136例,动脉瘤位于前交通动脉84例,颈内动脉80例,大脑中动脉64例,大脑前动脉9例,基底动脉3例,术前临床轻重程度按GCS计分分为15、14—13、12—7分三组,分别为117例、70例、53例。患者予后按术后六个月统计,分为恢复良好,中度恢复,严重致残,植物生存,死亡五级。根据术后是否发生脑血管痉挛分为三组:无痉挛组(临床无脑血管痉挛症状,CT正常);症状性痉挛组(出现脑血管痉挛症状,CT无低密度区);梗塞组(CT有低密度灶)。以上脑血管痉挛症状和CT低密度灶均除外手术操作,出血水肿等原因所致者。
Between 1981 and 1989, 482 patients with ruptured cerebral aneurysms were admitted to the study, of which 240 patients underwent surgery within one week. The author of this study, analysis of early postoperative cerebral vasospasm and prognosis. Age 19 ~ 74 years old, average 51.9 years old. 10 males and 136 females. The aneurysms were located in 84 cases of anterior communicating artery, 80 cases of internal carotid artery, 64 cases of middle cerebral artery, 9 cases of anterior cerebral artery and 3 cases of basilar artery. The preoperative clinical severity was classified by GCS 15,14-13,12-7 points for the three groups, respectively, 117 cases, 70 cases, 53 cases. Patients after six months according to statistics, divided into recovering, moderate recovery, severe disability, plant survival, death five. According to whether postoperative cerebral vasospasm is divided into three groups: no spasm group (clinical no cerebral vasospasm symptoms, normal CT); symptomatic spasm group (cerebral vasospasm symptoms, CT no low density area); infarction group (CT There are low-density stoves). More than the symptoms of cerebral vasospasm and CT low density lesions were excluded surgical operation, bleeding edema caused by other reasons.