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首页> 外文期刊>Oncology letters >Ultra-early microsurgical treatment within 24 h of SAH improves prognosis of poor-grade aneurysm combined with intracerebral hematoma
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Ultra-early microsurgical treatment within 24 h of SAH improves prognosis of poor-grade aneurysm combined with intracerebral hematoma

机译：SAH 24小时内的超早期显微手术治疗可改善不良级动脉瘤合并脑内血肿的预后

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摘要

Spontaneous subarachnoid hemorrhage (SAH) is the most common cerebrovascular disease. The conventional treatment for SAH is usually associated with high mortality. The present study aims to assess the prognosis of microsurgical treatment for patients with poor-grade aneurysm (Hunt and Hess grades IV-V) associated with intracerebral hematoma. A total of 18 consecutive patients who were diagnosed with poor-grade aneurysm accompanied with intracerebral hematoma were retrospectively recruited. All patients underwent microsurgical treatment between April 2010 and June 2013 at The 101st Hospital of Chinese People's Liberation Army (Wuxi, China). Among them, 15 cases underwent microsurgery within 24 h of SAH, and 3 cases underwent microsurgery 24 h following SAH. All 18 cases were examined by computed tomography angiography (CTA). The outcome was assessed during a follow-up time of 6-36 months. According to the Glasgow Outcome Scale, 4 patients experienced a good recovery, 6 were dissatisfied with the outcome, 4 were in vegetative state and 4 succumbed to disease. Poor outcome occurred in patients with an aneurysm diameter >10 mm, exhibited >50 ml volume of intracerebral hematoma or presented cerebral hernia prior to the surgical operation. The outcome of ultra-early surgery (within 24 h of SAH) was improved, compared with that of surgery following 24 h of SAH (P=0.005). Among 7 patients who accepted extraventricular drainage, good outcomes were achieved in 4 of them, whereas dissatisfaction and mortality occurred in 2 and 1 patients, respectively. Therefore, ultra-early microsurgery (within 24 h of SAH) combined with extraventricular drainage may improve the prognosis of patients with poor-grade aneurysm.
机译：自发性蛛网膜下腔出血（SAH）是最常见的脑血管疾病。 SAH的常规治疗通常与高死亡率相关。本研究的目的是评估伴有脑内血肿的差级动脉瘤（Hunt和Hess IV-V级）患者的显微外科治疗预后。回顾性收集了连续18例诊断为低级动脉瘤并伴有脑内血肿的患者。所有患者均于2010年4月至2013年6月在中国人民解放军第101医院（中国无锡）接受显微外科治疗。其中，SAH术后24 h进行显微外科手术15例，SAH术后24 h进行显微外科手术3例。所有18例均通过计算机断层血管造影（CTA）检查。在6-36个月的随访期间评估了结局。根据格拉斯哥成果量表，4例患者恢复良好，6例对结果不满意，4例处于营养状态，4例死于疾病。动脉瘤直径> 10 mm，显示> 50 ml体积的脑内血肿或在手术前出现脑疝的患者发生不良预后。与SAH 24小时后的手术相比，超早期手术（SAH的24小时内）的结果得到了改善（P = 0.005）。在接受脑室引流的7例患者中，其中4例获得了良好的预后，而2例和1例分别发生了不满意和死亡率。因此，超早期显微外科手术（在SAH内24小时内）结合脑室引流可以改善低级动脉瘤患者的预后。

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