Timing and perioperative care in intracranial aneurysm surgery.
Timing and perioperative care in intracranial aneurysm surgery.
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颅内动脉瘤手术的时机和围手术期护理。
DOI：
10.1093/neurosurgery/21.cn_suppl_1.79
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发表时间：
1974
期刊：
影响因子：
--
通讯作者：
E. Kosnik
中科院分区：
文献类型：
--
作者：
W. Hunt;E. Kosnik
颅内动脉瘤手术修复的合适时机是决定急性发作预后的最重要因素之一。手术修复的唯一目的是防止今后出血。只有很少的干预是指在急性病人，然后只有排出危及生命的血肿。保守治疗期间缺血性梗死死亡不能通过手术预防。由于最近的蛛网膜下腔出血，在脑循环仍然受损的情况下进行干预，其风险超过了该疾病的自然病程。最后一次出血恢复后，情况正好相反。然而，尽管完全恢复后动脉瘤破裂的风险极低，但随之而来的修复延迟增加了再出血的风险。
Appropriate timing of the operative repair of intracranial aneurysms is one of the most important factors in determining the outcome of the acute episode. The sole purpose of operative repair is to prevent future bleeding. Only rarely is intervention indicated in the acutely ill patient and then only to evacuate a life-threatening hematoma. Deaths due to ischemic infarction during the period of conservative therapy cannot be prevented by surgery. Intervention while the cerebral circulation is still impaired as a result of recent subarachnoid hemorrhage entails risks which exceed those of the natural course of the disease. The reverse is true after recovery from the last hemorrhage. However, although the risk of aneurysmorrhaphy after full recovery is extremely low, the attendant delay in repair increases the risk of rebleeding.