Kobayashi S, Sugita K, Tanizaki Y, Nakagawa F, Takemae T
Acta Neurochir (Wien). 1982;63(1-4):175-83. doi: 10.1007/BF01728870.
This study was undertaken to examine the differences in aneurysm statistics between University hospitals where subacute or chronic patients are primarily treated and University-affiliated hospitals where both acute and chronic cases are also admitted. In each hospital group, the transition of the statistics in the last decade was studied. The purpose of this study was also to see if any conclusion could be drawn regarding the surgical treatment of acute cases. The death rate for all aneurysm cases admitted is 8% at University hospitals, whilst that at affiliated hospitals is roughly 30% during the 1970s. The operative death rate at the University hospitals is 3%, whilst that at affiliated hospitals is 16% which improved at one affiliated hospital to 8% in the 1980-1981 period. Morbidity also improved in the latest series in the affiliated hospital. These improvements are considered to be de to the change of operative and postoperative policies for acute cases to: limited surgical indications for grade IV patients, extensive cisternal clot removal at the time of surgery, and oral administration of Ticlopidine, a new antiplatelet agent.
本研究旨在探讨主要治疗亚急性或慢性患者的大学医院与也收治急性和慢性病例的大学附属医院之间动脉瘤统计数据的差异。在每个医院组中,研究了过去十年统计数据的变化。本研究的目的还在于看看是否能就急性病例的手术治疗得出任何结论。大学医院收治的所有动脉瘤病例的死亡率为8%,而在20世纪70年代,附属医院的死亡率约为30%。大学医院的手术死亡率为3%,而附属医院的手术死亡率为16%,在一家附属医院,这一比例在1980 - 1981年期间降至8%。在附属医院的最新系列中,发病率也有所改善。这些改善被认为是由于对急性病例的手术和术后政策发生了变化,包括:对IV级患者限制手术指征、手术时广泛清除脑池内血凝块以及口服新型抗血小板药物噻氯匹定。