Transfusion During Or After The Operation Of Clipping Cerebral Aneurysm And The Effect For Vasospasm And Clinical Prognosis

Objective: To investigate the practice of blood transfusion during aneurysm surgery may do hame to the people whose aneurysm has been ruptured . Methods: We performed a retrospective analysis of hospital record including operitive,anesthetic,and nursing records,computed tomographic scans, four-vessel angiographic films and computed tomographic angiographic of 251 patients undergoing surgery for ruptured cerebral aneurysms at China-Jpan Lianyi Hospital at Changchun.We want to judge which factors is most related to transfusion intraoperatively and whether transfusion intraoperative does harm to clinical outcome and may contribute to vasospasm and whether it is necessary transfusion postoperatively. Result: A total 61 patients(24.3%)received an intraoperative blood transfusion (median number of units ,3;range,1 — 9).Preoperative factors associated with intraoperative blood use included patient age (P=0.002), aneurysm ruptured during surgery (P<0.05), the size of neck of aneurysms (P = 0.002), preoperative hematocrit ( P=0.002 ). Factors not associated with intraoperative blood transfusion included past medical history (including hypertension), hydrocephalus found by CT, aneurysm location. Patient who received an intraoperative transfusion required an average of 2.98±1.784 units.A total of 33 patients (13.1%) required a blood transfusion (median number of units , 0.2316) postoperatively including 18 who received blood intraoperatively(median number of units , 0.8156).Conclusion : Blood transfusin can be expected in 30% pantients.Reducing intraoperative ruptures may reduce the need for blood products.worse outcome is associated with intraoperative blood transfusion.We should carefully assessed to determine if it is necessary to received blood during or after cerebral aneurysm surgery .