Management strategy and prognosis analysis for poor -grade aneurysmal subarachnoid hemorrhage
10.3760/cma.j.issn.1008-6706.2015.24.021
- VernacularTitle:高分级动脉瘤性蛛网膜下腔出血治疗策略及预后分析
- Author:
Changwei GU
;
Xinmin ZHOU
;
Fuhua YE
;
Weidong XU
;
Heng GAO
;
Zhiqiang LI
- Publication Type:Journal Article
- Keywords:
Subarachnoid hemorrhage;
Intracranial aneurysm;
Microsurgery
- From:
Chinese Journal of Primary Medicine and Pharmacy
2015;(24):3745-3747,3748
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy of microsurgery and predictors of outcome for poor -grade aneurysmal subarachnoid hemorrhage(aSAH).Methods Clinical data of 43 patients of poor -grade aSAH who per-formed microsurgery were retrospectively analyzed.There were 30 patients with Hunt -Hess grade IV and 1 3 patients with grade V.24 patients received emergency operation(within 6hours after onset),1 6 patients received ultra -early operation(within first 24hours after onset).Outcome was assessed by Glascow Outcome Scale(GOS).Results Of 43 patients who received microsurgery,favorable outcome was achieved by 1 9 cases of 43 cases (44.2%),poor outcome was achieved by 1 6 cases of 43 cases (37.2%),the overall outcome of patients with Hunt -Hess grade IV was better than that with grade V(Z =-2.486,P =0.01 6).1 8 patients with intracerebral hematoma received ultra -early or emergency operation,effective surgical intervention(GOS≥3)achieved in 1 2 patients,there was no signifi-cant difference in prognosis between the patients and the others who without intracerebral hematomas(χ2 =0.1 03,P =1 .000).Conclusion The ultra -early or emergency surgery could avoid the risk of aneurysmal re -rupture,relieve malignant intracranial hypertension as soon as possible and decrease the mortality of poor -grade aSAH patients.
