The Effect Of Hunt-hess Redefining To Ruptured Cerebral Aneurysm Patients After Having Continuous Lumbar Cerebrospinal Fluid Drainage

Objective:To discuss the impact of the Hunt-Hess redemarcation to thetreatment of ruptured cerebral aneurysm patients after using continuous lumbarcerebrospinal fluid drainage (CLCFD). And provide a new thought to thepatients who get poor grades of the Hunt-Hess degree of subarachnoidhemorrhage (SAH) before surgery. To evaluate the influence of early CLCFDbefore the clipping and the embolization on patients’ complications andprognosis with aneurysmal subarachnoid hemorrhage (aSAH).Methods: A systematic review of the clinical data of319ruptured cerebralaneurysm patients who got CLCFD before the clipping and the embolizationfrom2011-10to2014-01in our hospital.After using CLCFD to the patients whogot poor grades of SAH. To review the Hunt-Hess degree,and decide whether ithas the indication of surgery.In addition,to compare them with the310caseswith no CLCFD during the same period in our hospital.To discuss thedifferences on recovery and complications of the two groups.Results:(1) In the patients of Hunt-Hess Ⅱ, the difference was statisticallysignificant based on using CLCFD (P<0.05).(2) Through the correlation inspection,to analyze the connection of the timeinterval of preoperation,different gender and different age with the prognosis,allwas not statistically significant.(P<0.05).(3) Based on ventricular expansion, Devide the patients of the classificationof Hunt-Hess Ⅲ-Ⅴ into two groups, the difference of their prognosis havestatistical significance in independent sample t-test.(P<0.05). (4) Compared with the no-drainage group,the CLCFD significantly reducedthe occurance rates of delayed ischemic neurological deficit(DIND) and cerebralvasospasm,and it didn’t increase the risk of intracranial infection.(P>0.05).Conclusion:(1) Generally, as to Hunt-Hess class Ⅰ~Ⅲ, preoperativeimaging examination should be completed actively, surgical treatment can beimplemented as soon as possible after preoperative preparation; It is good toreceive the CLCFD for the patients of Hunt-Hess IV-V, we can reappraise thegrade after the symptoms being improved, if the grade is not higher thanHunt-Hess Ⅲ.The clipping or the embolization of the aneurysms combined withCLCFD can significantly improve the quality of life and survival rate of aSAHpatients in poor grade of Hunt-Hess.(2) To the patients of aSAH, The CLCFD is a reasonable choice in theearly time, not only can improve the prognosis of patients and reduce theincidence of complications, and don’t increase the chance of intracranialinfection.(3) The CLCFD can reduce intracranial pressure and the brain volume,decrease the pull damage in the brain tissue during the operation,makes thesurgical field more clear, which has important clinical significance.(4) The CLCFD technique is a mini-invasive, safe and effective method,can effecttly prevent CVS, DIND and chronic hydrocephalus following aSAH,promote brain function recovery, can quickly relieved.