Hunt-hess Level2Aneurysm In Acute Stage Chnical Analysis Of Bone Flap Decompression

Objective:Discussion Hunt-Hess level2aneurysm in acute stage clinical efficacy of bone flapdecompressionMethod:Select the china-Japanese friendship Hospital of Jilin University second oversawFebruary2012-February2014Hunt-Hess level2patients with aneurysms, Inclusioncriteria were: CT diagnosis subarachnoid hemorrhage, CTA or DSA specificallycaused by hemorrhage due to a ruptured intracranial aneurysm. Exclude mergingimportant organs such as heart and Lung in patients with severe disease. To array andrandomly divided into bone flap decompression craniecto3my group，Postoperativeanti-Vasospasm,3H therapy and other treatment。There were84cases of Hunt-Hesslevel2aneurysm, in which38cases of bone flap decompression, non-bone flapdecompression group of46cases。Compared two groups of patients after24hours,72hours,7th day GCS score rate of improvement, after second surgery rates,incidence of symptomatic cerebral Vasospasm, and the incidence of delayedencephalopathy Hydrocephalus hyponatremia, postoperative half of GOS ratings。Results:To array and bone flap decompression craniectomy preoperative GCS score, agegroup, gender had no significant difference, between the two groups were comparable.Bone flap decompression unit after24hours,72hours,7th day GCS scoreimprovement rate significantly higher than the bone flap decompression group.Postoperative secondary bone flap decompression rate, rate of tracheotomy, surgeryfor symptomatic cerebral Vasospasm hyponatremia incidence, incidence ratesignificantly lower than non-bone flap decompression group. Two groups of patientswith no significant difference in the incidence of delayed encephalopathy after acutehydrocephalus, GOS score half a year after operation with no statistically significantdifferences. Analysis of patients with bone flap of second operation in the group, discovered their common characteristic for the preoperative CT shows subarachnoidhemorrhage is more hard film high tension, cerebral form the color red.Conclusion:Hunt-Hess level2bone flap decompression in acute aneurysms can effectivelyreduce intracranial pressure, it will help improve early postoperative, lower rates ofpostoperative secondary surgery rates, incision of trachea, incidence of symptomaticcerebral Vasospasm, the incidence of hyponatremia..