颅内动脉瘤性蛛网膜下腔出血不同时机开颅手术及血管内治疗的疗效及预后因素分析

doi:10.3969/j.issn.1006-6233.2017.01.021

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摘要 目的: 分析颅内动脉瘤性蛛网膜下腔出血(SAH)不同时机开颅术及血管内介入治疗的疗效差异以及预后不同。方法: 回顾性分析152例颅内动脉瘤性SAH患者的临床资料,依照Hunt-Hess分级法将所有患者分为两组,低分级(n=87,Ⅰ~Ⅲ级)和高分级(n=65,Ⅳ~Ⅴ级),应用格拉斯哥预后评分(GOS)评价患者预后,比较两组患者中早期、延期行开颅术及血管内介入术的效果差异。结果: 低分级中,早期行开颅术及血管内介入术的良好率高于延期治疗差异具有统计学意义(P均<0.05);高分级中,延期行开颅术及血管内介入术的良好率高于早期治疗差异无统计学意义(P均<0.05);低分级和高分级的行开颅术及血管内介入术的良好率差异无统计学意义(P>0.05)。结论: 手术时机是影响颅内动脉瘤性SAH治疗效果的重要因素,而手术方式与治疗效果无相关性,积极行开颅术及血管内介入术能够有效改善患者预后。

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	曾光
	洪明
	徐岩
	杨巨亮

关键词 ：蛛网膜下腔出血, 颅内动脉瘤, 开颅术, 血管内介术, 手术时机

Abstract：Objective: To analyze the difference for efficacy and prognosis of craniotomy at different time and endovascular therapy for SAH. methods: The clinical data of 152 patients with subarachnoid hemorrhage caused by ruptured aneurysm were analyzed retrospectively, and were divided into two groups according to Hunt-Hess classification, the low grade group(n=87, Ⅰ~Ⅲ level)and the high grade group(n=65, Ⅳ~Ⅴlevel). The GOS was applied to evaluate the prognosis of patients. The effect of craniotomy in the early process and endovascular intervention of two groups was compared. Results: In the low grade group, the good rate of craniotomy and endovascular intervention in the early process was higher than that of delayed treatment(P<0.05). In the high grade group, the good rate of craniotomy and endovascular intervention of delayed treatment was higher than that of early treatment(P<0.05). The difference for the good rate of craniotomy and endovascular intervention between low grade and high grade was not evident(P>0.05). Conclusion: Operation time is an important factor influencing treatment effect of subarachnoid hemorrhage caused by ruptured aneurysm, but operation method has no correlation with treatment effect. Taking craniotomy and endovascular intervention actively can effectively improve the prognosis.

Key words： Subarachnoid hemorrhage Intracranial aneurysm Craniotomy Endovascular intervention Operation time

基金资助:辽宁省2015年自然科学基金计划立项项目,(编号:2015020552)

引用本文:

曾光, 洪明, 徐岩, 杨巨亮. 颅内动脉瘤性蛛网膜下腔出血不同时机开颅手术及血管内治疗的疗效及预后因素分析[J]. 河北医学, 2017, 23(1): 63-64.
ZENG Guang, HONG Ming, XU Yan, et al. Analysis on Efficacy and Prognostic Factors of Craniotomy at Different Time and Endovascular Therapy for Subarachnoid Hemorrhage Caused by Ruptured Aneurysm. HeBei Med, 2017, 23(1): 63-64.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2017.01.021 或 http://www.hbyxzzs.cn/CN/Y2017/V23/I1/63