颅内破裂动脉瘤手术时机和预后关系的临床研究

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1、分类号——ICS学校代码!Q!墨鱼学号2Q!Q凶!璺Z委；莩～差一岛蒙名民庆大学硕士学、．又颅内破裂动脉瘤手术时机和预后关系的临床研究TheOperationTimingofRupturedIntracranialAneurysmandtheClinicalStudyontheRelationshipofPrognosis申请人：朱彬学科专业：中西医结合临床研究方向：蒙西医结合外科学学位类别：专业学位指导教师：孙志刚教授论文提交日期：二O一三年四月摘要目的：探讨颅内破裂动脉瘤手术时机和预后的关系。方法：回顾性分

2、析2010年9月～2012年9月我科收治的60例颅内破裂动脉瘤病人的临床资料。60例病人全部行动脉瘤夹闭术，按入院时Hunt&Hess分级分为I～II级、III级和Ⅳ～V级三组，根据手术时间分为早期手术组30例(蛛网膜下腔出血3d内手术)和晚期手术组30例(蛛网膜下腔出血11d后手术)，出院时行GOS(GlasgowOutcomeScale)评分，分析不同手术时机对预后的影响。结果：通过统计学分析，早期和晚期手术组的Hunt&HessI"--III级的患者预后差异无统计学意义(P>0．05)：Hunt&Hess

3、lV级以上的患者预后差异无统计学意义(P>O．05)。但再出血率早期手术组低于晚期手术组；早期手术组脑缺血发生率低于晚期手术组：早期手术组的脑积水发生率较晚期手术组低。结论：Hunt&Hess分级I"-III级的患者应早期接受手术治疗，Hunt&Hess分级IV～V级的患者早、晚期手术均可。关键词：颅内动脉瘤；手术时机；预后TheOperationTimingofRupturedIntracranialAneurysmandtheClinicalStudyontheRelationshipofPrognosis

4、AbStractObjective：Investigatetherelationshipbetweentheoperationtimeofrupturedintracranialaneurysmandtheclinicalprognosis．Methods：Clinicaldataof60casesofpatientswithrupturedintracranialaneurysminourdepartmentwereanalyzedretrospectivelyfromSep．2010toDec．2012，a

5、ndallthe60patientswereunderarterialaneurysm．The60patientsweredividedpreoperativelyinto3Classes一一一ClassofHunt-HessI-II，ClassofHunt-HessIII，andClassofHunt．HessIV-VAccordingtotheoperationtime，30caseswerearrangedintheearlyoperationgroup(SubaractmoidHemorrhageope

6、rationwithin3days)andanother30caseswereinthelateoperationgroup(SubarachnoidHemorrhageoperationafter1days)．ScoretheGOS(GlasgowOutcomeScale)afterthetreatmentSOastoanalyzetheprognosisinfluencedbythedifferentoperationtime．Results：Therewasnostatisticallysignifica

7、ntdifferencesintheprognosis(P>0．05)amongpatientsofHunt&HessI～IIIbetweentheearlyoperationgroupandlateoperationgroup．Therewasnostatisticallysignificantdifferencesintheprognosis(P>0．05)inpatientsofHunt&HesstV．However,therateofrebleedingintheearlyoperationgroupi

8、slowerthanthatinthelateoperationgroup．Theincidenceofcerebralischemiainthelateoperationgroupishigherthanthatintheearlyoperationgroup．Theincidenceofhydrocephalusintheearlyoperationgroupislowerthan