The treatment of patients with ruptured intracranial aneurysms of hunt-hess Ⅲ-Ⅳ grade in the cerebral vasospasm stage
10.3760/cma.j.issn.1008-6706.2010.15.001
- VernacularTitle:颅内动脉瘤破裂患者脑血管痉挛期的治疗
- Author:
Xuejun ZHANG
;
Wei LIANG
;
Wenjun CHEN
- Publication Type:Journal Article
- Keywords:
Intracranial aneurysms;
Embolization;
Intravascular therapy
- From:
Chinese Journal of Primary Medicine and Pharmacy
2010;17(15):2017-2019
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the reasonable treatment to the patients with raptured intracranial aneurysms of hunt-hess Ⅲ-IV grade in the cerebral vasospasm stage. Methods The clinical data of 80 patients with ruptured intracranial aneurysms of hunt-hess Ⅲ-IV grade were analyzed retrospectively. All of the patients were clipped closed by microsurgery (36) or embolized intervention(44) in 3～18 days after disease. According to the time of surgical intervention after disease,they were divided into 42 patients with early(3～10 days) surgical group and 38 patients with advanced(11～18 days) surgical group. The different operative methods and different treatment periods were compared in order to evaluate the effect to the prognosis, the DIND incidence and the ruptured again aneurysms during operation incidence. Results There was no statistical significance in the effect about early or advanced surgical intervention to the prognosis, the DIND incidence and the ruptured again aneurysms during operation incidence (P > 0.05). There was no statistical significance in the effect about advanced interventional embolization or clipping closed by microsurgery to the prognosis,the DIND incidence and the ruptured again aneurysms during operation incidence(P > 0. 05). There was statistical significance in the effect about early interventional embolization or clipping closed by microsurgery to the prognosis,the DIND incidence and the ruptured again aneurysms during operation incidence(P< 0.05). The interventional embolization had better prognosis,more lower DIND incidence and more lower ruptured a-gain aneurysms during operation incidence than the clipping closed by microsurgery. Conclusion The patients with ruptured intracranial aneurysms of hunt-hess Ⅲ-IV grade in the cerebral vasospasm stage should be earlier intervened surgically,then it seems that interventional embolization is more reasonable which is worth referencing in clinic. The good operation habits during operation and the effectively strengthening management after operation had positive significance to ensure operative effect and to improve prognosis.
