Clinical analysis of 60 cases of recurrent hemorrhage after ruptured intracranial aneurysm / 中国基层医药

ABSTRACT

Objective@#To investigate the clinical features of rebleeding after ruptured intracranial aneurysms.@*Methods@#A retrospective analysis was made on the diagnosis and treatment of 60 patients with ruptured intracranial aneurysms from February 2017 to February 2018 in Taizhou Hospital.According to the patients' rebleeding, the patients were divided into the control group and the observation group, with 30 cases in each group.The patients' medical records were collected.The causes, time periods, clinical manifestations and time intervals and times of rebleeding were analyzed.At the same time, the position and size of the aneurysm, the Hunt-Hess score and the combination of hypertension in the two groups were compared.@*Results@#The causes of rebleeding in the observation group were intraoperative rupture, premature movement and ambulation, defecation, abnormal mood and no obvious inducement.Preoperative rebleeding occurred in 24 cases 19 cases before admission, 4 cases after admission, 1 case before and after admission, and 6 cases of bleeding during operation.The clinical manifestations of rebleeding in the observation group were apnea, pathological reflex, one side/bilateral pupil, light hemiplegia, meningeal irritation, and systemic convulsion and ankylosis.In the observation group, the proportions of patients with bleeding below 8d, 8-14d, 15-21d, 22-30d and more than 30d were 46.67%, 23.33%, 13.33%, 10.00% and 6.67%.There were no statistically significant differences in the position and size of the aneurysm between the two groups (all P>0.05). The Hunt-Hess scores of grade Ⅰ, Ⅱ, Ⅲ, Ⅳ in the observation group were 33.33%, 40.00%, 16.67% and 10.00%, respectively, and the Hunt-Hess scores of grade Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ in the control group was 10.00%, 36.67%, 30.00%, 20.00% and 3.33%, respectively, the difference was statistically significant (u=2.507, P=0.012). There was no statistically significant difference in the incidence of hypertension between the two groups (χ2=0.161, P>0.05).@*Conclusion@#The recurrence of intracranial aneurysms is not related to the location and size of aneurysms, and the association between hypertension and disease.It is closely related to the Hunt-Hess score.