摘要
目的:探讨Hunt-HessⅣ-Ⅴ级颅内动脉瘤破裂应用超早期血管内介入治疗的效果。方法:回顾性分析86例的Hunt-HessⅣ-Ⅴ级颅内动脉瘤破裂患者的临床资料,依照介入手术干预时机的不同,将患者分为试验组给予超早期血管内介入治疗(发病48 h内进行栓塞手术治疗)和常规组给予延期血管内介入治疗(发病48~96 h内进行栓塞手术治疗),每组43例。比较两组患者手术时间、术中出血量、住院时间,出院后3个月巴塞尔指数(BI)、出院时格拉斯预后评分(GOS)、术后格拉斯昏迷评分(GCS)及并发症发生情况。结果:两组患者Hunt-Hess分级、手术时间及住院时间等比较差异无统计学意义(均P>0.05)。术前,两组患者GCS评分以及BI指数比较差异无统计学意义(均P>0.05);出院时,两组患者GCS评分、BI指数均较术前上升(均P<0.05),且试验组水平明显高于常规组(P<0.05)。两组患者出院时GOS评分均上升(P<0.05),且试验组明显高于常规组(P<0.05)。试验组并发症发生率(6.98%)低于常规组(27.91%)(P<0.05)。结论:相比延期血管内介入治疗Hunt-HessⅣ-Ⅴ级颅内动脉瘤破裂患者,超早期血管内介入治疗的效果更好,患者预后良好,且不增加并发症发生率,安全可靠。
Objective:To investigate the effect of ultra early intravascular interventional therapy for Hunt-Hess gradeⅣ-Ⅴintracranial aneurysm rupture.Methods:The clinical data of 86 patients with Hunt-Hess gradeⅣ-Ⅴruptured intracranial aneurysms were retrospectively analyzed.According to the different timing of interventional surgery,the patients were divided into experimental group(embolization within 48 hours of onset)and routine group(embolization within 48 to 96 hours of onset),with 43 cases in each group.The operation time,intraoperative bleeding volume,hospital stay,Basel index(BI)3 months after discharge,Glasgow Outcome Scale(GOS)at discharge,Glasgow Coma Scale(GCS)after operation and the incidence of complications were compared between the two groups.Results:There was no significant difference in Hunt-Hess classification,operation time and hospitalization time between the two groups(all P>0.05).Before operation,there was no significant difference in GCS score and BI between the two groups(all P>0.05).At discharge,the GCS score and BI of the two groups were higher than those before operation(all P<0.05),and the level of the experimental group was significantly higher than that of the routine group(P<0.05).The GOS score of patients in both groups increased at discharge(all P<0.05),and the experimental group was significantly higher than the routine group(P<0.05).The incidence of complications in the experimental group was lower than that in the conventional group(6.98%vs.27.91%,P<0.05).Conclusion:Compared with delayed intravascular interventional therapy for Hunt-Hess gradeⅣ-Ⅴintracranial aneurysm rupture patients,ultra early intravascular interventional therapy has better effect,good prognosis,and does not increase the incidence of complications,which is safe and reliable.
作者
罗显华
何明海
罗长稳
张纯化
李铭辉
LUO Xianhua;HE Minghai;LUO Changwen;ZHANG Chunhua;LI Minghui(Department of Neurosurgery,Ankang Central Hospital,Ankang 725000,China)
出处
《陕西医学杂志》
CAS
2022年第11期1360-1363,共4页
Shaanxi Medical Journal
基金
陕西省安康市科学技术研究发展计划项目(AK2020-SF-14)。
