颅内动脉瘤性蛛网膜下腔出血不同时机开颅手术及血管内治疗疗效及预后因素探析.docVIP

颅内动脉瘤性蛛网膜下腔出血不同时机开颅手术及血管内治疗疗效及预后因素探析 　　[摘要] 目的 对颅内动脉瘤性蛛网膜下腔出血不同时机开颅手术及血管内治疗的疗效及预后因素进行研究。方法 从2014年3月―2016年5月来该院治疗颅内动脉瘤性蛛网膜下腔出血的患者中方便选取144例进行分析，采用Hunt-Hess 分级法将其分为低级组（84例）、和高级组（60例），对两组患者在早期、延期两个不同时机，血管内治疗、开颅手术两种不同手术方式下两组患者的治疗效果进行分析。 结果 低级别组治疗手段一样前提下手术时机进行比较，两种手术方式下早期治疗的疗效都明显比延期要好。而高级别组延期手术治疗效果比早期手术治疗效果要好。 结论 颅内动脉瘤治疗和手术时机关系密切，但与手术方式无关。对颅内动脉瘤性蛛网膜下腔出血患者进行血管介入治疗以及开颅手术等可以促进患者尽快康复，使患者预后明显改善，对提高患者的生命质量具有重要意义 [关键词] 颅内动脉瘤；蛛网膜下腔出血；血管内治疗；预后；手术时机 [中图分类号] R743.35 [文献标识码] A [文章编号] 1674-0742（2017）02（b）-0078-03 [Abstract] Objective To research the curative effect and prognosis factor of craniotomy and endovascular treatment at different time for subarachnoid hemorrhage caused by ruptured aneurysms. Methods 144 cases of patients with Subarachnoid hemorrhage caused by ruptured aneurysms treated in our hospital from March 2014 to May 2016 were convenient selected for analysis and divided into the junior group with 84 cases and senile group with 60 cases， and the patients were respectively treated with Craniotomy and endovascular treatment at early and postponed stages， and the treatment effect of patients in the two groups was analyzed. Results The curative effect of the two operation methods in the early stage was better than that in the postponed stage in the junior group， and in the senile group， and the treatment effect of postponed operation was better than that in the early stage. Conclusion The intracranial aneurysm treatment is related to the operation time， but has no relationship with the operation method， and the endovascular intervention treatment and craniotomy for patients with subarachnoid hemorrhage caused by ruptured aneurysms can promote the rapid recovery and obviously improve the prognosis， which is of important significance to improving the quality of life of patients. [Key words] Intracranial aneurysm； Subarachnoid hemorrhage； Endovascular treatment； Prognosis； Operation time 在脑血管疾病中颅内动脉瘤性蛛网膜下腔出血较为常见，发病率很高，仅比高血压脑出血以及脑血栓要低，发生的主要原因是颅内动脉瘤导致了蛛网膜下腔出血，该病在不