Clinical Research On The Timing Of Interventional Embolization Operation In Treatment Of Ruptured Intracranial Aneurysm

Objective: To discuss the effect of endovascular embolization in the incidence of complications and recurrence rate.And then to compare the prognostic effects of high grade groups and low grade groups in patients with different timing of interventional embolization.Materials and methods: 62 patients with ruptured intracranial aneurysms admitted to The First Affiliated Hospital of Dalian Medical University from October 2013 to October 2015 were retrospectively analyzed.The data includes gender,age,and HuntHess classification,the number of aneurysm,distribution of aneurysm,degree of embolization,postoperative complications,whether or not aneurysm recurrence,discharge status and quality of life in the after half a year.Preoperative above all patients were diagnosed with have subarachnoid hemorrhage(SHA)by CT examinations,and preoperative patients have been were definitely diagnosed as intracranial aneurysms CTA or DSA.Preoperative phenobarbital and atropine as preoperative routine medication.The operations were performed under general anesthesia by endotracheal intubation and systemic heparinization.All patients were performed by neurosurgeons(associate professor or above),performing according to the routine interventional manipulation.According to the Hunt-Hess classification,the early operation(within 3 days)of 42 patients grouped by level,40 of them are low grade group(I-III),high-grade group(IV-V)2;the delayed operation(more than 4 days)20patients were grouped by level,which low-level group has 14,high-level group has 6.The success rate of embolization in the early group and the delayed group were compared by chi-square test to observed if there was statistical significance;and to compare the prognostic effect,postoperative complications and recurrence of low gradegroup and high grade group after interventional embolization with different operation time whether statistical differences.Results: The success rate of embolism in early group patients was 95.2%,the success rate of embolism in delayed group patients was 80.0%,The overall success rate of embolization was 90.0%.Thus,the success rate of early endovascul embolization group was higher than that of late embolization group.The difference is statistically significant(P < 0.05).The good rate was 95.0% in patients with low grade group receiving early intervention,The good rate of the delayed treatment was 42.8%,thus it can be seen,The effect of early embolization treatment was better than that of delay group,the difference is statistically significant(P < 0.05);The good rate of early intervention in the patients of high grade group was 50.0%,The good rate of the delayed embolization group was 66.6%.The effect of delayed embolization was better than that of early stage,the difference was statistical significance(P < 0.05).The incidence of postoperative complications was 9.5%,the recurrence rate was 4.8% in the early embolization group;the complication rate was 45.0%,the recurrence rate was 15%in the patients with delayed embolization group.The incidence of complications and recurrence rate of early embolization group were lower than those in the advanced group,and the difference was statistically significant(P<0.05).Conclusion: the rupture of intracranial aneurysms is very dangerous,therefore,to achieve early discovery,early diagnosis,early rational choice suitable timing of embolism treatment in the clinic.Interventional embolization for patients with less trauma,postoperative recovery fast,so interventional embolization should be used as far as possible in all patients while there were no clear contraindications.Through this group,we found that early treatment of aneurysm embolization can significantly improve the success rate of embolization,and reduce postoperative complications and recurrence rate.There were differences in the efficacy of early and late surgery for patients with different grades;There were differences in the efficacy of early and late intervention in patients with low grade.For patients with low grade,the successrate of early intervention embolization was higher,and the curative effect is better;for patients with high level,the efficacy of early embolization and delayed embolization is inconclusive,and further research is needed.