动脉瘤破裂致蛛网膜下腔出血24 h内微弹簧圈栓塞干预的预后分析  

Prognosis of subarachnoid hemorrhage caused by ruptured aneurysm treated by coil embolization within 24h

作　　者：黄明火 熊学辉[1] 魏小川[1] 罗杰[1] Huang Minghuo;Xiong Xuehui;Wei Xiaochuan;Luo Jie(Department of Neurosurgery,Huanggang Central Hospital,Huanggang 438000,China)

机构地区：[1]黄冈市中心医院神经外科

出　　处：《中华神经创伤外科电子杂志》2019年第3期155-158,共4页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

摘　　要：目的分析动脉瘤破裂致蛛网膜下腔出血24h内行微弹簧圈栓塞干预的预后。方法纳入2014年1月至2017年6月黄冈市中心医院神经外科收治的127例动脉瘤破裂致蛛网膜下腔出血患者进行回顾性分析,将24h内接受微弹簧圈栓塞患者纳为超早期组(71例),将≥24h患者纳为非超早期组(56例)。对比2组患者围手术期疗效及术后6个月的预后。结果超早期组术前再出血、术后脑梗死及脑积水发生率均明显低于非超早期组,差异有统计学意义(P<0.05)。2组患者院内死亡率对比,差异无统计学意义(P>0.05)。2组患者术后6个月的改良Rankin量表评分比较,差异无统计学意义(P>0.05)。结论对动脉瘤破裂致蛛网膜下腔出血患者在24h内开展微弹簧圈栓塞术治疗,虽然能够减少术前再出血风险和术后并发症发生率,但对显著提升患者预后并无明显作用。Objective To analyze the prognosis of subarachnoid hemorrhage caused by ruptured aneurysm treated by coil embolization within 24 h. Methods One hundred and twenty-seven patients with subarachnoid hemorrhage caused by ruptured aneurysms were enrolled in the Department of Neurosurgery of Huanggang Central Hospital from January 2014 to June 2017. Cases received embolization within 24 h were involved in the ultra-early group (71 cases),inclusion of patients over 24 h into non-ultra-early group (56 cases). The perioperative efficacy and prognosis at 6 months after operation were compared between the two groups. Results The incidence of preoperative rebleeding,postoperative cerebral infarction and hydrocephalus in the ultra-early group was significantly lower than that in the non-ultra-early group (P<0.05). There was no significant difference in hospital mortality between the two groups (P>0.05). There was no significant difference in the modified Rankin scale (mRs) scores between the two groups at 6 months after operation (P>0.05). Conclusion For patients with subarachnoid hemorrhage caused by ruptured aneurysm,coil embolization within 24 h can reduce preoperative rebleeding,postoperative cerebral infarction and hydrocephalus,but it does not significantly improve the prognosis of the patients.

关 键 词：颅内动脉瘤 蛛网膜下腔出血 微弹簧圈栓塞 手术时机 

分 类 号：R651.1[医药卫生—外科学]