[1]徐苑源　李建明　沈洪波.Hunt-Hess分级ⅢⅣ级颅内动脉瘤的手术时机选择及预后分析[J].中国临床神经外科杂志,2018,(06):410-412.[doi:10.13798/j.issn.1009-153X.2018.06.009]
　XU Yuan-yuan,LI Jian-ming,SHEN Hong-bo..Surgical timing and prognosis of patients with Hunt-Hess grade Ⅲ and Ⅳ aneurysms[J].,2018,(06):410-412.[doi:10.13798/j.issn.1009-153X.2018.06.009]
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Hunt-Hess分级ⅢⅣ级颅内动脉瘤的手术时机选择及预后分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2018年06期
页码:
410-412
栏目:
论著
出版日期:
2018-06-25

文章信息/Info

Title:
Surgical timing and prognosis of patients with Hunt-Hess grade Ⅲ and Ⅳ aneurysms
文章编号:
1009-153X（2018）06-0410-03
作者:
徐苑源　李建明　沈洪波
作者单位：643000 四川，自贡市第三人民医院神经外科（徐苑源、李建明、沈洪波）
Author(s):
XU Yuan-yuan;  LI Jian-ming;  SHEN Hong-bo.
Department of Neurosurgery, Zigong Municipal Third People`s Hospital, Zigong 643000, China
关键词:
颅内动脉瘤; Hunt-Hess分级Ⅲ~Ⅳ级; 手术时机; 预后
Keywords:
Ruptured intracranial aneurysm;  Hunt-Hess grade Ⅲ~Ⅳ;  Surgical timing;  Prognosis
分类号:
R 743.9; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2018.06.009
文献标志码:
A
摘要:
目的 探讨Hunt-Hess分级Ⅲ~Ⅳ级颅内动脉瘤手术时机与预后的关系。方法 回顾性分析2015年1月至2017年12月显微手术治疗的90例Hunt-Hess分级Ⅲ~Ⅳ级颅内动脉瘤的临床资料，根据发病至手术时间分为早期组（<3 d，38例）、中期组（3~10 d，20例）、晚期组（>10 d，32例）。结果 早期组预后良好率（89.47%）明显高于中期组（60.00%，P<0.05）、晚期组（68.75%，P<0.05），脑血管痉挛发生率（5.26%）明显低于中期组（30.00%，P<0.05）、晚期组（25.00%，P<0.05）。多因素Logsitic回归分析显示，早期手术治疗可获得更好的近期预后（OR=1.813，90%CI：1.294~2.641）。结论 Hunt-Hess分级Ⅲ~Ⅳ级颅内动脉瘤建议早期（<3 d）手术治疗，可降低脑血管痉挛发生率，改善病人预后。
Abstract:
Objective To investigate the relationship between the microsurgical timing and the prognosis of patients with Hunt-Hess grade Ⅲ and Ⅳ aneurysms. Methods The clinical data of 90 patients with Hunt-Hess grade Ⅲ~Ⅳ aneurysms, who were treated by microsurgery in our department from January, 2015 to December, 2017, were analyzed retrospectively. According to the time from onset of rupture to surgery, the patients were divided into 3 groups, i.e. early group (within 3 days after the rupture, 38 cases), medium-term group (3~10 days, 20 cases) and late group (more than 10 days, 32 cases). The short-term prognoses and the incidences of complications were compared among the groups. Results The excellent and good rate of prognosis (89.47%, 34/38) was significantly higher in the early group than those [(60.00%, 12/20) and (68.75%, 22/32) respectively] in the medium-term group and late group (P<0.05). The incidence of cerebral vasospasm (5.26%, 2/38) was significantly lower in the early group than those [(30.00%, 6/20) and (25.00%, 8/32) respectively] in the medium-term and late groups (P<0.05). There were insignificant differences in the excellent and good rate of the prognosis and incidence of cerebral vasospasm between the late and the medium-term groups (P>0.05). The binary Logsitic regression analysis showed that the short-term prognosis of the early surgical treatment on the Hunt-Hess Ⅲ~Ⅳ patients with ruptured aneurysms was significantly better than those of the medium-term and late microsurgery (OR=1.813, 90%CI: 1.294~2.641). Conclusion The microsurgical treatment should be performed within 3 days in the Hunt-Hess grade Ⅲ~Ⅳ patients with ruptured intracranial aneurysms in order to improve their prognoses.

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更新日期/Last Update: 2018-06-25