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

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Abstract 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-Ⅴaneurysmal 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 Hunt-Hess high grade aneurysmal subarachnoid hemorrhage is better than that of delayed operation.

Key words： Hunt-Hess grade Aneurism Subarachnoid hemorrhage Early operation Delayed operation

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	Articles by authors
	XIE Fei
	LIU Hong-bin
	CHEN Zhi-yuan
	ZENG Jia-liang
	YE Yong-qiang
	HAO Jian-qiang
	LIU Huan

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XIE Fei,LIU Hong-bin,CHEN Zhi-yuan, et al. Clinical effect of early craniotomy in the treatment of Hunt-Hess high grade aneurysmal subarachnoid hemorrhage[J]. 中国当代医药, 2020, 27(10): 13-16.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2020/V27/I10/13

[1]	Vlak MH，Algra A，Brandenburg R，et al.Prevalence of unruptured intracranial aneurysms，with emphasis on sex，age，comorbidity，country，and time period：A systematic review and meta-nalysis[J].Lancet Neurol，2011，10（7）：626-636.
[2]	秦军，李新建，黄宽明，等.显微手术治疗颅内动脉瘤[J].中国临床神经外科杂志，2006，11（11）：658-660.
[3]	张力，王汉东，潘云曦，等.大脑中动脉动脉瘤的显微手术夹闭治疗[J].中国脑血管病杂志，2019，16（2）：66-71.
[4]	薄金红，岑立勉.开颅夹闭术和血管内栓塞术治疗颅内动脉瘤的临床观察[J].吉林医学，2019，40（2）：338-339.
[5]	谢飞，陈志远，曾家良，等.基层医院后交通动脉瘤的显微手术治疗[J].华西医学，2014，29（4）：679-681.
[6]	朱军武，高永峰，周国胜.早期显微手术夹闭瘤颈治疗脑动脉瘤破裂出血的疗效分析[J].中国实用神经疾病杂志，2016，19（23）：113-114.
[7]	Luo YC，Shen CS，Mao JL，et al.Ultra-early versus delayed coil treatment for ruptured poor-grade aneurysm[J].Neuroradiology，2015，57（2）：205-210.
[8]	Tykocki T，Czyz M，Machaj M，et al.Comparison of the timing of intervention and treatment modality of poor-grade aneurismal subarachnoid hemorrhage[J].Br J Neurosurg，2017，31（4）：430-433.
[9]	Zhao B，Zhao Y，Tan X，et al.Factors and omcomes associated with ultra-early surgery for poor-grade aneurysmal subarachnoid hemorrhage：a multicenter retrospective analysis[J].BMJ Open，2015，5（4）：e007410.
[10]	何雪峰，梁建涛，王向阳，等.高级别颅内动脉瘤暂行保守治疗后手术或血管内栓塞预后的观察[J].中国脑血管病杂志，2015，12（4）：199-202.
[11]	张力，王汉东，潘云曦，等.前交通动脉瘤破裂合并颅内血肿的超早期显微手术治疗效果分析[J].中国脑血管病杂志，2019，16（6）：303-309.
[12]	Ironside N，Buell TJ，Chen CJ，et al.High-grade aneurysmal subarachnoid hemorrhage：predictors of functional outcome[J].World Neurosurg，2019，125：e723-e728.
[13]	De Oliveira Manoel AL，Mansur A，Silva GS，et al.Functional outcome after poor-grade subarachnoid hemorrhage：a single-center study and systematic literature review[J].Neurocritical Care，2016，25（3）：338-350.
[14]	Taylor CJ，Robertson F，Brealey D，et al.Outcome in poor grade subarachnoid hemorrhage patients treated with acute endovascular coiling of aneurysms and aggressive intensive care[J].Neurocdt Care，2011，14（3）：341-347.
[15]	郑匡，田作富，谭显西，等.早期治疗高分级动脉瘤性蛛网膜下腔出血的一年预后因素多中心研究[J].中华神经外科杂志，2016，54（7）：534-539.
[16]	徐跃峤，王宁，胡锦，等.重症动脉瘤性蛛网膜下腔出血管理专家共识（2015）[J].中国脑血管病杂志，2015，12（4）：215-224.
[17]	Lee JY，He Y，Sagher O，et al.Activated autophagy pathway in experimental subarachnoid hemorrhage[J].Brain Res，2009，1287：126-135.
[18]	Schuette AJ，Barrow DL.Treatment of ruptured middle cerebral aneurysms associated with intracerebral hematomas[J].World Neurosurg，2013，80（3-4）：266-267.
[19]	Fujinaka TL，Yoshimine T，Mashimo T.Management of aneurysmal subarachnoid hemorrhage[J].Masui，2012，61（9）：962-970.
[20]	梁明礼，何海勇，秦峰，等.颅内动脉瘤破裂并颅内血肿形成的早期显微外科手术治疗[J].中华神经医学杂志，2015，14（6）：572-575.
[21]	Nanda A，Patra DP，Maiti TK，et al.Microsurgical clipping of broad neck A1 segment aneurysm：technical note：3-dimensional operative video[J].Oper Neurosurg（Hagerstown），2018，14（1）：88.
[22]	Paine JT，Batjer HH，Samson D.Intraoperative ventricular puncture[J].Neurosurgery，1988，22（6 Pt 1）：1107-1109.