Abstract：Objective To summarize the clinical experience of early surgical treatment of aneurysmal subarachnoid hemorrhage with Hunt-Hess gradeⅢandⅣ.Methods 60 patients with aneurysmal subarachnoid hemorrhage with Hunt-Hess gradeⅢandⅣadmitted in our hospital from January 2008 to December 2013 were selected.They were all confirmed by 3D-CTA examination including 39 cases of early surgery(＜72 h),and 21 cases of delayed surgery(3～10 d).The clinical curative effect of the patients was observed,and the effect of early surgery and delayed surgery on the therapeutic efficacy were analyzed.Results The situation of early surgical prognosis group was better than that of delayed surgery group (P＜0.05).No recurrence of postoperative bleeding was observed,and 5 cases were died.Conclusion In the treatment for the patients with aneurysmal subarachnoid hemorrhage with Hunt-Hess gradeⅢ andⅣ,the prognosis of the patients receiving early surgery is significantly better than that of delayed operation.
Steiner T，Juvela S，Unterberg A，et al.European Stroke Organization Guidelines for the Management of Intracranial Aneurysms and Subarachnoid Haemorrhage[Z].Cerebrovasc Dis，2013：93-112.
Jartti P，Isokangas JM，Karttunen A，et al.Early rebleeding after coiling of ruptured intracranial aneurysms[J].Acta Radiol，2010，51（9）：1043-1049.
[9]
Molyneux AJ，Kerr RS，Birks J，et al.Risk of recurrent subarachnoid haemorrhage，death，or dependence and standardised mortality ratios after clipping or coiling of an intracranial aneurysm in the International Subarachnoid Aneurysm Trial （ISAT）：long-term follow-up[J].Lancet Neurol，2009，8（5）：427-433.
[13]
Karamessini MT，Kagadis GC，Petsas T，et al.CT angiography with three-dimensional techniques for the early diagnosis of intracranial aneurysms.Comparison with intra-arterial DSA and the surgical findings[J].Eur J Radiol，2004，49（3）：212-223.
[14]
Dawkins AA，Evans AL，Wattam J，et al.Complications of cerebral angiography：a prospective analysis of 2，924 consecutive procedures[J].Neuroradiology，2007，49（9）：753-759.
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