颅内破裂动脉瘤手术时机选择对患者手术疗效及预后的影响

颅内破裂动脉瘤手术时机选择对患者手术疗效及预后的影响吴华伟;屈洪艳
【期刊名称】《医学综述》
【年(卷),期】2015(21)7
【摘要】目的：探讨颅内破裂动脉瘤患者不同手术时机与患者临床疗效及预后的关系。

方法选择2007年6月至2012年6月湖北医药学院附属东风医院收治的198例颅内破裂动脉瘤患者为研究对象，根据不同手术时机分为两组：观察组（ n ＝100）给予早期手术治疗（手术距末次发病的时间≤3 d），对照组（n＝98）先予以保守对症治疗，然后给予中期手术治疗（手术距末次发病的时间＞4 d），采用改良Rankin 量表（ MRS）评分比较两组患者的术后状态，并比较不同组间术后再出血、脑积水、脑血管痉挛发生率及预后生存情况。

结果两组患者术后的MRS 评分差异有统计学意义（ U ＝8.403，P＝0.015），观察组的预后良好率显著高于对照组。

两组术后再出血、脑积水、脑血管痉挛等并发症发生率对比差异均无统计学意义（均P＞0.05）。

患者随访观察100 d，观察组与对照组的组间生存率经Log－rank检验，差异无统计学意义（χ2＝0.822，P＝0.663）。

结论颅内破裂动脉瘤患者早期手术可改善患者预后，晚期手术会增加患者再出血风险，但是否有利于预后恢复尚需扩大样本量进行研究。

%Objective To investigate the correlation between surgical timing and clinical prognosis in patients with ruptured intracranial aneurysms.Methods The retrospective analysis was conducted and reported based on the clinical data of 198 patients with ruptured intracranial aneurysms from Hubei Medical Affiliated Dongfeng Hospital during Jun.2007 and Jun.2012,who were categorized into two
groups according to the different surgery timing.The treatment group(n =100) were given early surgical treatment (surgery from late onset time ≤3 d),the control group(n=98) were given the conservative symptomatic treatment, and then give the mid-term surgery ( surgery from the last incidence time>4 d) .The modified rankin scale MRS scores,the incidence of preoperative rebleeding,hydrocephalus,cerebral angiospasm and survival were analyzed in the two groups.Results The MRS scores of between the two groups were statistically significant
(U=8.403,P=0.015),the good prognosis rate of the treatment group was significantly higher.The inci-dence of complications such as postoperative rebleeding , hydrocephalus, cerebral vasospasm compared between the two groups did not show statistically significant difference
( P>0.05 ) .Patients were followed up for 100 days,and the survival rates tested by log-rank test of the two groups showed no statistically significant difference(χ2 =0.822,P=0.663).Conclusion The early surgery may improve the prognosis of patients with ruptured intracranial aneurysms while the late surgery may increase the risk of
rebleeding ,though larger sample quantity is needed to make the conclusion that it is good for the prognosis and recovery.
【总页数】3页(P1290-1291,1292)
【作者】吴华伟;屈洪艳
【作者单位】湖北医药学院附属东风医院神经外科，湖北十堰 442000;湖北医药学院附属东风医院神经外科，湖北十堰 442000
【正文语种】中文
【中图分类】R651.11
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