早期开颅手术治疗Hunt-Hess高分级动脉瘤性蛛网膜下腔出血的临床效果  

Clinical effect of early craniotomy in the treatment of Hunt-Hess high grade aneurysmal subarachnoid hemorrhage

作　　者：谢飞[1] 刘红彬 陈志远[1] 曾家良 叶勇强[1] 郝建强[1] 刘欢[1] XIE Fei;LIU Hong-bin;CHEN Zhi-yuan;ZENG Jia-liang;YE Yong-qiang;HAO Jian-qiang;LIU Huan(Department of Neurosurgery,the First People′s Hospital of Ziyang,Sichuan Province,Ziyang641300,China)

机构地区：[1]四川省资阳市第一人民医院神经外科,四川资阳641300

出　　处：《中国当代医药》2020年第10期13-16,共4页China Modern Medicine

基　　金：四川省资阳市科技成果转移转化项目(2018CZ-S-06)。

摘　　要：目的探讨早期开颅手术治疗Hunt-Hess高分级动脉瘤性蛛网膜下腔出血的临床效果,总结早期手术治疗动脉瘤的临床经验。方法回顾性分析2013年7月~2017年12月我院收治的42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,按照手术时间不同将其分为早期手术组和延期手术组,早期手术组(≤72 h)26例,延期手术组(>72 h)16例。统计两组患者术中脑肿胀发生情况,出院后采用格拉斯哥预后量表(GOS)评估两组患者的预后。结果早期手术组患者术中脑肿胀发生率高于延期手术组,差异有统计学意义(P<0.05)。早期手术组患者的GOS分级优于延期手术组,差异有统计学意义(P<0.05)。结论早期开颅手术治疗Hunt-Hess高分级动脉瘤性蛛网膜下腔出血患者的预后情况优于延期手术。Objective To exlpore the clinical effect of early craniotomy in the treatment of Hunt-Hess high grade aneurysmal subarachnoid hemorrhage, so as to summarize the clinical experience of early operation for aneurysms.Methods The clinical data of 42 patients with Hunt-Hess grade Ⅳ-Ⅴ aneurysmal subarachnoid hemorrhage treated in our hospital from July 2013 to December 2017 were retrospectively analyzed. They were divided into early operation group and delayed operation group according to different operation time. There were 26 patients in early operation group(≤72 h) and 16 patients in delayed operation group(>72 h). The incidence of intraoperative brain swelling in the two groups was counted, and the Glasgow outcome scale(GOS) was used to assess the prognosis of the two groups after discharge. Results The incidence rate of intraoperative brain swelling in patients in the early operation group was higher than that in the delayed operation group, and the difference was statistically significant(P<0.05). The GOS grade of patients in the early operation group was better than that in the delayed operation group, and the difference was statistically significant(P<0.05). Conclusion The prognosis of early craniotomy in the treatment of patients with HuntHess high grade aneurysmal subarachnoid hemorrhage is better than that of delayed operation.

关 键 词：HUNT-HESS分级 动脉瘤 蛛网膜下腔出血 早期手术 延期手术 

分 类 号：R743.4[医药卫生—神经病学与精神病学]