| objectiveTo study of aneurysm embolization after subarachnoid hemorrhage the relationship between clinical outcomes analysis effect relationships and TCM syndromes.MethodsIncluded in the December 2012-2015 in January subarachnoid hemorrhage patients Guangdong Provincial Hospital of General Hospital encephalopathy encephalopathy three subjects a subject and intracranial aneurysm embolization, collecting patient’s age, sex, incidence of solar terms, Hunt-Hess grading, aneurysm site, whether multiple, whether high blood pressure, whether diabetes, smoking, drinking habits, whether heart disease, whether Chinese medicine, yin or yang syndrome, TCM syndromes, GOS score during follow aneurysm, TCM conditions and other relevant information, according to the discharge or death GOS score prognostic evaluation outcomes, retrospective study analyzed the impact has been in intracranial aneurysm embolization prognosis factors and TCM syndromes.Results1. A total of 80 cases included patients, including 27 males and 34% of the total,53 females, accounting for 66% of the total. Women significant number of patients than male ones, the youngest 35 years old, the oldest 94 years old, the average age ranged from 58.32 ± 12.24 years. Over gender and age chi-square test results by sex, age aSAH embolism prognosis for patients no significant correlation. From the onset of solar terms, the maximum incidence of frost, White Dew, the autumnal equinox and the onset Xiaoman least from the onset.quarter, summer hair less than normal.2. ASAH embolization in 80 patients,39 cases had hypertension,6 cases of diabetes, hyperlipidemia 9 cases,10 cases of heart disease, smoking in 15 cases,10 cases of drinking. These are not prognostic factors.3. Responsibility aneurysm cases:posterior communicating artery aneurysm in 25 cases,19 cases of anterior communicating artery aneurysm, anterior cerebral artery aneurysms paragraph 9 patients, vertebral artery aneurysm paragraph 6 cases, basilar artery aneurysm in 6 cases, middle cerebral artery there are five cases of tumors, other segments of the internal carotid artery in 10cases. Afterthe most traffic distribution, distribution of responsibility . aneurysm before the main loop.4. Hunt-Hess grade:grade Ⅰ 2 people (2.5%), Ⅱ grade 20 (25%), grade Ⅲ 28 people (35%), grade Ⅳ 14 people (17.5%), Ⅴ grade 16 (20%). The Hunt-Hess grade included rank-sum test described in the prognosis of patients with embolic Hunt-Hess grade aSAH related.5. Peri operative:25 cases of patients with pulmonary infection,20 cases of patients with cerebral vasospasm,14 cases of patients with hydrocephalus, intracranial infection was 13 cases,12 cases of patients with urinary tract infections, gastrointestinal tract there are five cases of bleeding in patients with epilepsy have two cases, four cases of new onset of acute cerebral infarction in. The perioperative into line derived statistical tests, hydrocephalus, lung infection, cerebral vasospasm was statistically significant, suggesting hydrocephalus, lung infection, cerebral vasospasm is aSAH embolism prognostic factors.6. TCM Syndrome Study:"liver-yang hyperactivity, Wind & Fire on the interference" Syndromes have 52 cases, "Wind & Fire on the disturbing orifices" There are 13 cases, "phlegm organs fact, the wind phlegm" There are two cases, "phlegm network" There is one case, "scrambling wind phlegm stasis" There is one case. TCM type more as a "liver yang hyperactivity, Wind & Fire on One," based. Certified as 78 cases yang yin Syndrome only two cases. TCM Distribution and Responsibility aneurysm no correlation, while circulation and distribution before and after no correlation. "Liver-yang hyperactivity, Wind & Fire on the disturbance, " "on the disturbing orifices, Wind & Fire" syndromes included in the statistical test results were statistically significant, indicating that factors aSAH embolism prognosis. Plus 70 cases of patients with traditional Chinese medicine decoction treatment, accounting for 87.5%,10 cases of patients with no decoction treatment, accounting for 12.5%. The decoction included in the statistical test results using embolization outcomes decoction no significant correlation.7. Surgical methods:21 cases of selecting the stent assisted coil embolization,59 cases are simple coil embolization, surgical options and prognosis.8. Follow-up situation:aSAH embolization in 80 patients in this study were of five died during hospitalization, the patient was discharged 75 cases,65 cases of these patients follow-up study in which 27 patients are admitted to hospital follow-up, the entire line of the head and neck vessels imaging or total cerebral angiography and found four cases of aneurysm recurrence, not bleeding again, and again the line aneurysm embolization, embolization dense discharged without discomfort. The remaining 53 cases have telephone follow-up, the majority of patients with good prognosis.Conclusion1. Patients mostly women, average age of onset is about 58.32±12.24 years, from the onset of solar terms, the frost maximum number of cases, from the onset quarter, autumn, winter, spring festival incidence significantly, while the incidence of the summer at least. Age, gender had no correlation with prognosis.2. Hunt-Hess grade, "liver-yang hyperactivity, Wind & Fire on the disturbance," "on the disturbing orifices, Wind & Fire", cerebral vasospasm, pulmonary infection, hydrocephalus is the prognostic factors, logistic regression analysis included results "liver-yang hyperactivity, Wind & Fire on One" and Hunt-Hess grade iii and v grade level is an independent risk factor for embolism aSAH prognosis. And hydrocephalus, cerebral vasospasm more serious, the better the prognosis, clinical experience with severe does not, whether there is a clear multicollinearity between variables further by co-linear regression model yields diagnostic characteristic value, condition index, the proportion of variance You can determine the value of each variable does not exist multicollinearity. Hydrocephalus, cerebral vasospasm severity of clinical experience do not match, too little consideration is due to sample size, it still is an independent risk factor.3. Responsibility aneurysm cases, liability aneurysm located in the largest after transportation, before the main loop.4. TCM syndrome distribution and the distribution of responsibilities aneurysm no correlation. aSAH TCM multi belong to the "liver-yang hyperactivity, Wind & Fire on the disturbance," which is an independent risk factor for embolism aSAH prognosis. Early onset of "wind", "Fire," which may be related to liver yang hyperactivity of the wind, blood intrinsic, Yun-long heat, wind, fire, with fan, wind, fire, blood stasis influence each other, heat syndrome significantly. ASAH early treatment of patients, to expelling wind, phlegm, fire, town of liver yang, heat-based, one hospital 27 patients were followed up with Qi and Phlegm-stasis based, post-treatment needs further study. |
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