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目前对颅内动脉瘤破裂的最佳手术时间尚有争论,存在着两种对立的观点:一种是1970～1979年间主张的晚期手术(出血后0～第8天)血管痉挛消失后才进行手术,手术效果好,但此期有出血复发的危险,死亡率可达6％。另一种是自1980年起主张的早期手术(出血后0～第3天)优点是可阻止出血复发,缺点是术后血管痉挛及脑缺血的危险性大,死亡率为7％。早期、晚期手术的死亡率几乎相等,而致死原因各异。作者根据他1990～1993年处理动脉瘤所致SAH 77例的经验,进行分析如下:
At present, there is still controversy about the optimal operative time for rupturing an intracranial aneurysm. There are two opposing views: one is advanced surgery (0 to 8 days after hemorrhage) advocated in 1970-1979, before vasospasm disappears Surgical operation, the effect is good, but the risk of recurrence of bleeding during this period, the mortality rate of up to 6%. The other is the early surgery advocated from 1980 (0 to 3 days after bleeding) advantage is to prevent the recurrence of bleeding, the disadvantage is the postoperative vasospasm and cerebral ischemia risk, the mortality rate was 7%. Mortality in early and late surgeries is almost the same, and the causes of death vary. The author based on his treatment of aneurysms in 1990 to 1993, 77 cases of SAH experience, analysis is as follows: