高分级动脉瘤性蛛网膜下腔出血的早期手术治疗

发布时间：2019-05-22 14:19

【摘要】：目的探讨高分级动脉瘤性蛛网膜下腔出血的临床特点及早期手术治疗效果。方法回顾性分析36例Hunt-Hess分级Ⅳ、Ⅴ级动脉瘤性蛛网膜下腔出血患者的临床资料。其中,Ⅳ级28例,Ⅴ级8例;显微手术夹闭28例,介入治疗8例。采用出院时格拉斯哥预后评分(GOS)评价患者的预后。结果 2例患者术后出现脑积水并行脑室腹腔分流术,3例出现肺部感染。Hunt-Hess分级Ⅳ级患者预后良好21例,预后不良7例,Ⅴ级患者预后良好3例,预后不良5例,预后良好比分别为75%(21/28)、37.5%(3/8),两组预后比较差异有统计学意义(P0.05);显微手术夹闭治疗的患者预后良好18例,预后不良10例,死亡3例;介入治疗的患者预后良好6例,预后不良2例,预后良好比分别为64.29%(18/28)、75%(6/8),两者比较预后差异无统计学意义(P0.05)。结论 Hunt-Hess分级Ⅳ级的患者应根据患者综合情况选择合适的手术方式争取早期手术治疗,Ⅴ级患者早期手术治疗效果尚有待进一步研究。
[Abstract]:Objective to investigate the clinical characteristics and early surgical treatment of high grade aneurysm subarachnoid hemorrhage. Methods the clinical data of 36 patients with Hunt-Hess grade IV and V aneurysm subarachnoid hemorrhage were analyzed retrospectively. There were 28 cases of grade IV, 8 cases of grade V, 28 cases of microsurgical clamping and 8 cases of interventional therapy. The prognosis of the patients was evaluated by Glasgow prognosis score (GOS) at discharge. Results 2 patients had hydrocephalus complicated with intraventricular shunt and 3 patients had pulmonary infection. 21 patients with Hunt-Hess grade IV had good prognosis, 7 patients had poor prognosis, 3 patients with grade V had good prognosis and 5 patients had poor prognosis. The good prognosis ratio was 75% (21 鈮，

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