Hunt-Hess Ⅳ～Ⅴ级动脉瘤性蛛网膜下腔出血的早期血管内治疗

Analysis of intravasoular treatment for H＆H Hunt-Hess Ⅳ～Ⅴgrade aneurysmal subarachnoid hemorrhage patients in early stage

目的探讨Hunt-Hess Ⅳ～Ⅴ级蛛网膜下腔出血患者的处理方案。方法：回顾性分析同时期采用早期血管内冶疗的34例颅内动脉瘤患者和保守治疗的21例患者的结果，比较两组临床资料及总体治疗效果的差异。结果两组临床资料比较差异无统计学意义，具有可比性（P〉0．05）；早期栓塞组34例预后良好21例，残疾7例，死亡6例；保守治疗21例中良好5例，残疾4例，死亡12例；两组比较疗效差异有统计学意义（X^2=12．61，P〈0．01），死亡率差异有统计学意义（X^2=9．47，P〈0．01）。结论Hunt-Hess Ⅳ～Ⅴ级颅内动脉瘤性蛛网膜下腔出血病人应早期行血管内治疗。

Objective To discuss the curative effects of intravascular treatment for H＆H Ⅳ～Ⅴgrade subarachnoid hemorrhage patients, in early stage. Nethods 34 cases of intracranial aneurysm of H＆H Ⅳ～Ⅴgrade were treated by intravascular embolism and 21 cases accepted conservative treatment in early stage, their clinical data were analized ,by comparing the clinical data and curative effects. Results There were no significant difference in the clinical materials of two groups （P〈0.05）,in 34 cases accepted intravascular embolism, 21 cases obtained a no deformity outcome, 7 cases with obvious deformity, 6 cases dead ;the conservative treatment group , the corresponding result were 5 cases well, 4 cases deformitive, 12 cases dead. The prognosis was better in intravascular treatment group than that in conservative group ,significant difference between two groups was affirmed ;statistically （x^2= 12.61, P〈0.01）, and there was sinnificant difference between two groups in mortality rate （x^2=9.47, P〈0.01）.Conclusion The patients with Hunt Hess Ⅳ～Ⅴgrade aneurysmal subarachnoid hemorrhage should accept early intravascular embolism treatment.