The Effects Of Rehaemorrhagia And Prognosis On The Patients With Ruptured Intracranial Aneurysms Suffering Conveying

[Background] As the development of CTA ,DSA,MRA and other digitized image techenique recent years,those unfolding in big polyclinics hospitals make the patients with SAH be made a definite diagnosis .About 85% patients are diagnosed as ruptured intracranial aneurysms.On the other hand,With the development of minimally invasive neurosurgery,the treatment level of aSAH have made great progress. And then the remedial trategy of SAH alter from medical treatment mainly into surgery treatment.But recently only the big polyclinics have the capability to treat the desease with intracranial aneurysm and interventional therapy techenique.Most substrate hospitals are even short of necessary inspection devices. It can't be avoided to convey the patients with aSAH for prompt treatment. But traditional view is that such patients should lay up for 4 - 6 weeks and avoid unnecessary movement or even check. It's thought that long-distance conveying will enhance the risk .The view is still popular ,and the treatment to many patients with ruptured intracranial aneurysm are delayed.So it is necessary to study the effects of rehaemorrhagia and prognosis on the patients with aSAH suffering conveying.So that we can make sure conveying'safety and feasibility.[Methods] Consulted the 327 cases of patients with intracranial aneurysms who were accepted by our hospital during Dec 1 2002 and Nov 30 2007.Chose 309 aSAH cases with complete clinical data .Among them, 57 cases received first diagnosis in our hospital while 252 cases transferred from other hospitals.121 cases transferred to our hospital within 3 days after hemorrhage(54 cases within 1 days),52 cases within 4-7 days,79 cases after 8 days.The average hours for conveying was 2.64±1.66 hours. The average distance for conveying was 175.9±123.5km.Patients were graded by Hunt-Hess after admission.Among patients receiving first diagnosis in our hospital,7 cases is 1 grade,30 cases 2 grade,14 cases 3 grade,5 cases 4 grade,1 case 5 grade.Among patients conveying from other hospitals, 98 cases is 1 grade,92 cases 2 grade,41 cases 3 grade,19 cases 4 grade,2 cases 5 grade. Among them,248 cases received craniotomy treatment,7 cases received interventional embolism.31 cases refused treatment and leave hospital after change better.23 cases were taken expectant treatment because of the eld , Hunt-HessIV-V grade , medical complication,big fusiform basilar artery aneurysm and so on. The patiens'prognostic evaluation were all standarded by GOS scores when they leave hospital.[Results] There are only 3 cases with rehaemorrhagia on admission day.There are no differences on rehaemorrhagia rate between first diagnosis in our hospital and conveying from other hospital on conveying day.There are no statistical differences on rehaemorrhagia rate between the transfer treatment distance less than 100 km and more than 100 km on conveying day. The rehaemorrhagia rate are high for conveying patients within 24 hours after haemorrhagia.which is relation to the natural rehaemorrhagia rate , but not to the conveying.The patients'prognostic is relation to the Hunt-Hess scores not to the conveying distance,or whether the patients are conveyed or not.[Conclusions] Conveying doesn't enhance the rate of hemorrhagia and doesn't affect the prognosis.So it should be active to transfer if necessary.And it must keep the blood pressure steady and avoid kinds of complicating disease during the conveying.