Analysis Of The Results Of Surgical Treatment Of Intracranial Aneurysms Of Hunt&Hess Grade Ⅳ And Ⅴ

Objective: To know the result of conservative treatment and surgical treatment of patients with intracranial aneurysms of Hunt&Hess gradeⅣand V , in order to provide basis for clinical treatment.Methods: Through the retrospective analysis of quality of life of the patient with intracranial aneurysms of Hunt-Hess gradeⅣand V of the Second Hospital of Hebei Medical University from January 2003 to August 2009 when patients were discharged, (not including the existence of breathing and / or circulatory failure, as well as those who gave up treatment)to compare whether there were differences of the effects between surgical treatment and conservative treatment. There were 81 cases reviewed, Male 35 cases, female 46 cases, male: female = 1:1.314, the average age was 54±10.3 years old .among of which the patients of surgical treatment were 44 cases(operation group), the patients of conservative treatment were 37cases(non-operative group). Among non-operative group, Male16 cases, female 21 cases, the average age was 51.4±11.3 years old. Among operation group, male 19 cases, female 25 cases, the average age was 49.3±10.6 years old.According to the different time interval from onset to surgery, early surgery group were 21 cases (The time interval between the onset and the operation <3 days ), intermediate surgery group were 7 cases (The time interval between the onset and the operation was 4-14 days) and delayed surgery group were16 cases (The time interval between the onset and the operation >14 days). Through the evaluation of quality of life of discharge with GOS grade, the patient with good prognosis was GOS≥IV grade and the patient with bad prognosis was GOS≤III grade. SPSS 13.0 software was used for statistical analysis to the level of good prognosis between surgical treatment and conservative treatment, With P<0.05 for the different statistically significant. Results:1 The comparison of gender and age of the patient of Hunt&Hess gradeⅣandⅤbetween operation group and conservative group had no obvious change.2 The comparison of the rate of good prognosis of the patient of Hunt&Hess gradeⅣandⅤbetween operation group and conservative group. 8 cases survived in 37 cases of conservative treatment, 3cases had a good prognosis, 29 cases died; the rate of good prognosis was 8.1%.28 cases survived in 44 cases in operation group, 12 cases had a good prognosis, 16 cases died, the rate of good prognosis was 27.3%. There was a significant difference between operation group and conservative group (X2 =4.892,P=0.027<0.05).Conclusions:The data indicated surgical treatment is superior to conservative treatment to the patient of Hunt&Hess gradeⅣandⅤ.