显微夹闭术时机对脑动脉瘤破裂出血的疗效影响

Effect of Timing of Microscopic Clipping Surgery on the Curative Effect of Ruptured Cerebral Aneurysm Hemorrhage

目的分析显微夹闭手术时机对脑动脉瘤破裂出血的疗效影响。方法选取2018年1月至2020年1月期间接收的脑动脉瘤破裂出血患者86例进行回顾性分析研究,所有患者均行脑动脉瘤显微夹闭手术治疗,其中于动脉瘤破裂出血<72 h予以手术治疗的44例患者作为<72 h组,于动脉瘤破裂出血≥72 h进行手术治疗42例患者作为≥72 h组,术后对纳入病例随访3个月,依据GOS预后结局评估量表评估预后。比较两组的手术耗时、手术中失血量、住院时长、术后并发症发生状况以及术后3个月的预后状况。结果两组手术时长、手术失血量、住院时长相比较,差异无统计学意义(P>0.05);<72 h组并发症发生率显著低于≥72 h组(P<0.05);<72 h组预后状况优于≥72 h组(P<0.05)。结论与脑动脉瘤出血≥72 h行显微夹闭术相比,在脑动脉瘤出血<72 h行显微夹闭术治疗的脑动脉瘤破裂出血患者,可明显改善预后,降低术后并发症的发生风险。

Objective To analyze the effect of timing of Microscopic clipping operation on ruptured cerebral aneurysm hemorrhage.Methods A retrospective analysis of 86 patients with ruptured cerebral aneurysm hemorrhage received from January 2018 to January 2020 was conducted,all the 86 patients underwent microclipping operation for cerebral aneurysm.Among them,the patients who received surgical treatment after aneurysm rupture and hemorrhage<72 h(44 cases)were regarded as<72 h group,and the patients who received surgical treatment after aneurysm rupture and hemorrhage≥72 h(42 cases)were regarded as≥72 h group.The included patients were followed up for 3 months after surgery.The prognosis was evaluated according to THE GOS outcome Assessment Scale.The duration of operation,blood loss during operation,length of hospital stay,postoperative complications and prognosis 3 months after operation were compared between the two groups.Results There were no significant differences in operative duration,operative blood loss and appearance in hospital between the two groups(P>0.05).The complication rate of<72 h group was significantly lower than that of≥72 h group(P<0.05).The prognosis of<72 h group was better than that of≥72 h group(P<0.05).Conclusion Compared with microclipping for cerebral aneurysm hemorrhage≥72 h,patients with ruptured cerebral aneurysm hemorrhage treated with microclipping for cerebral aneurysm hemorrhage<72 h can significantly improve prognosis and reduce the risk of postoperative complications.