动脉瘤手术时机对蛛网膜下腔出血患者血管痉挛和死亡率的影响。

The effects of timing of aneurysm surgery on vasospasm and mortality in patients with subarachnoid hemorrhage.

机构信息

Dr. Lütfi Kirdar Kartal Research and Training Hospital, First Neurosurgery Clinic, Istanbul, Turkey.

出版信息

Acta Neurol Belg. 2011 Dec;111(4):317-20.

Abstract

OBJECTIVE

The purpose of the present study was to compare the effects of early and late surgery on postoperative vasospasm and mortality in patients with subarachnoid hemorrhage (SAH).

METHODS

The data of patients with SAH who underwent aneurysmal clipping at the Kartal Training and Research Hospital between 1999 and 2005 were retrospectively analyzed. The patients who underwent early (0-3 days) and late surgery (> or = 4 days) were evaluated as two groups. Patient outcomes were assessed 1 month after surgery.

RESULTS

Of 159 patients (mean age, 49 years; 71 males) with SAHs, 135 (mean age, 51 years; 55 males) underwent early surgery and 24 patients (mean age, 56 years; 16 males) underwent late surgery. The overall postoperative vasospasm rate was 10.7%. The rate of postoperative vasospasm was significantly higher in the late surgery group (41.7%) compared to the early surgery group (5.2%; p < 0.001). There were 15 post-operative deaths (9.4%). The mortality rate in the late surgery group (25.0%) was significantly higher than the early surgery group (6.7%; p = 0.005).

CONCLUSIONS

The present study has demonstrated that early surgery is advantageous over late surgery in patients with SAH with lower post-operative vasospasm and mortality rates.

摘要

目的

本研究旨在比较蛛网膜下腔出血（SAH）患者早期和晚期手术对术后血管痉挛和死亡率的影响。

方法

回顾性分析 1999 年至 2005 年在卡塔尔培训与研究医院接受动脉瘤夹闭术的 SAH 患者数据。将早期（0-3 天）和晚期（≥4 天）手术的患者分为两组。术后 1 个月评估患者结局。

结果

159 例 SAH 患者（平均年龄 49 岁，71 例男性）中，135 例（平均年龄 51 岁，55 例男性）接受早期手术，24 例（平均年龄 56 岁，16 例男性）接受晚期手术。总的术后血管痉挛发生率为 10.7%。晚期手术组（41.7%）的术后血管痉挛发生率明显高于早期手术组（5.2%；p<0.001）。术后有 15 例死亡（9.4%）。晚期手术组（25.0%）的死亡率明显高于早期手术组（6.7%；p=0.005）。