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目的 探讨颅内动脉瘤破裂出血后急诊手术夹闭术中,控制再出血的安全和有效的方法。方法 DSA造影明确诊断同时预置不可脱球囊于载瘤颈内动脉内,继行开颅清除血肿,显微手术夹闭动脉瘤。在显露瘤颈或术中再出血时充盈球囊,暂时阴断血流。结果 4例前循环HuntⅣ-Ⅴ级动脉瘤病人经治疗后DSA复查动脉瘤完全消失,3例随访1～2年,2例恢复良好,1例伴有轻瘫和语言障碍,另1例术后60d,脑积水行脑室-腹腔分流后仍昏迷,偏瘫。结论 载瘤动脉内预置不可脱球囊是保证手术顺利完成,控制再出血安全有效的方法。
Objective To investigate the safe and effective method of controlling the rebleeding during the emergency operation after intracranial aneurysm rupture and bleeding. Methods DSA angiography with definite diagnosis at the same time preset non-detachable balloon in the carrying carotid artery, followed by craniotomy to remove the hematoma, microsurgery clip aneurysm. In revealing neoplasms or intraoperative filling again when the balloon bleeding, temporarily cloudy blood flow. Results The aneurysms disappeared completely in 4 cases of anterior circulation Hunt Ⅳ-Ⅴ grade aneurysms after DSA. Three cases were followed up for 1-2 years. Two cases recovered well, one was accompanied by paresis and speech disorders, and the other one was postoperative 60d, hydrocephalus line ventricle - peritoneal shunt still coma, hemiplegia. Conclusion It is safe and effective to control the rebleeding of the non-detachable balloon in the parent artery.