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首页> 外文期刊>Neurosurgery >Endovascular Treatment for Poorest-grade Subarachnoid Hemorrhage in the Acute Stage: Has the Outcome Been Improved?
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Endovascular Treatment for Poorest-grade Subarachnoid Hemorrhage in the Acute Stage: Has the Outcome Been Improved?

机译：急性期最差的蛛网膜下腔出血的血管内治疗：结果是否得到改善？

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OBJECTIVE: Patients with poor-grade subarachnoid hemorrhage (SAH) have been considered good candidates for endovascular treatment. The results of treatment of Grade V SAH, the poorest grade, however, have not been fully elucidated. METHODS: The clinical characteristics and outcome parameters of 22 World Federation of Neurosurgical Societies Grade V SAH patients treated endovascularly in the acute stage between 1998 and 2000 are summarized and compared with those of 18 Grade V SAH patients treated conservatively between 1995 and 1997. RESULTS: Among the 22 patients treated endovascularly, 8 patients (36.4%) survived. The rate was significantly higher than that of the 18 patients treated conservatively (5.6%), only one of whom survived. The favorable outcome rate, however, was not significantly different between the two groups (4.5% versus 6.0%). Subdivision of both treatment groups according to Glasgow Coma Scale (GCS) score showed that the improved survival among those treated endovascularly was attributable to the improved survival in those with a preprocedural GCS score of 6 but not of 4 or 5. CONCLUSION: Endovascular treatment of the 22 World Federation of Neurosurgical Societies Grade V SAH patients improved their survival rate but not their favorable outcome rate in comparison with conservative treatment. Further accumulation of clinical data is essential to determine whether endovascular treatment can improve the functional outcome of those with GCS scores of 6 and whether there is no role for endovascular treatment in those with GCS scores of 4 or 5.
机译：目的：严重蛛网膜下腔出血（SAH）患者被认为是血管内治疗的良好候选人。然而，尚未完全阐明最差等级V级SAH的治疗结果。方法：总结了1998年至2000年间22例世界急性神经外科协会V级SAH病人的临床特征和预后参数，并将其与1995年至1997年间18例保守治疗的V级SAH病人的临床特征和结果参数进行比较。在22例接受血管内治疗的患者中，有8例（36.4％）存活。该比率显着高于保守治疗的18例患者（5.6％），其中只有1例存活。然而，两组的有利结局率没有显着差异（4.5％对6.0％）。根据格拉斯哥昏迷量表（GCS）评分对两个治疗组进行了细分，结果表明，经血管内治疗的患者的生存率提高归因于术前GCS评分为6但不为4或5的患者生存率提高。与保守治疗相比，22个世界神经外科协会联合会V级SAH患者的生存率提高了，但其预后率却没有改善。进一步积累临床数据对于确定血管内治疗是否可以改善GCS得分为6的患者的功能结局以及对于GCS得分为4或5的患者是否对血管内治疗没有作用至关重要。

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