4d,3d,1</sup> 周、2周、3周、1年及長期生存率分別為 66.2%.26.0%.12.3%.5.8%.1 .1.9% 和 1.3% 。222例手術(shù)治療的患者中，行顯微手術(shù)夾閉治療的有145例，其中位生存時間是 <sup>1296d,3d,3</sup> 周、3個月、1年及長期生存率分別為 89.0% 、69.0%.62.1%.57.2% 和 47.6% ；行介入栓塞有77例，其3日、3周、3個月、1年及長期生存率分別為98.7%.81.8%.71.4%.70.1% 和 66.2% 。Log-rank 檢驗發(fā)現(xiàn)不同治療方式對生存率影響有明顯差異（ P< 0.01)，不同手術(shù)方式對生存率影響也存在明顯差異( P<0.05 )。根據(jù)mRS評分，不同治療方式患者的預(yù)后存在明顯差異( P<0.01 )，保守治療的預(yù)后更差;不同手術(shù)方式患者的預(yù)后也存在明顯差異，介入栓塞的預(yù)后更好( P<0.01 ）。結(jié)論高分級腦動脈瘤性蛛網(wǎng)膜下腔出血患者短期病死率高，手術(shù)治療能明顯改善預(yù)后，延長患者壽命，特別是介人栓塞術(shù)。-龍源期刊網(wǎng)" />

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不同治療方式對高分級動脈瘤性蛛網(wǎng)膜下腔出血患者生存時間的影響

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【中圖分類號】 R651 【文獻標志碼】 A 【文章編號】1672-7770（2025）03-0278-07

Abstract： ObjectiveTo investigate the impact treatment methods on the survival status patients with poor-grade aneurysmal subarachnoid hemorrhage.MethodsThe clinical data 376 patients with Hunt Hess grade IV- V cerebral aneurysmal subarachnoid hemorrhage in the Hospital from October 2O14 to December 2021 were analyzed retrospectively. The Kaplan Meier method was used to describe the distribution survival time and the Log-rank test was used to analyze the influence diferent treatment methods on survival time.One year after onset，the prognosis patients was evaluated with the modified Rankin scale（mRS）. ResultsAmong the 376 patients，154 patients were treated conservatively and 222 patients were surgically treated. The median survival time patients with conservative treatment was 4 days. The three-day，one-week，two-week，three-week，one-year and long-term survival rates were 66.2% ， 26.0% ， 12.3% ， 5.8% ， 1.9% and 1.3% ，correspondingly. Among 222 surgically treated patients，145 patients received micro-clipping surgery，whose median survival time was 1 296 days. The three-day，one-week，two-week， three-week，one-year and longterm survival rates were 89.0% ， 69.0% ， 62.1% ， 57.2% and 47.6% ，correspondingly. Seventyseven patients underwent interventional embolization.The three-day，one-week，two-week，threeweek，one-year and long-term survival rates were 98.7% ， 81.8% ， 71.4% ， 70.1% and 66.2% ， correspondingly. The results the Log-rank test indicated a strong correlation between treatment methods，surgical modes，and survival rates（all P<0.05 ）．According to the mRS scores，there were significant differences in prognosis among patients with different treatment methods（ P<0.01） and conservative treatment showed poorer outcomes. Similarly， significant diferences were observed in prognosis among patients with different surgical approaches，where interventional embolization demonstrated better outcomes （ P<0.01 ）.ConclusionsThe short-term mortality patients with poor-grade aneurysmal subarachnoid hemorrhage was high. Surgical treatment， especially interventional embolization，could significantly improve prognosis and extend the life the patients.

Key words： aneurysmal subarachnoid hemorrhage； microsurgical clipping； interventional embolization；conservative therapy；survival analysis

動脈瘤性蛛網(wǎng)膜下腔出血（aneurysmalsubarachnoidhemorrhage，aSAH）是第三大常見的腦卒中形式，約有 20%～40% 為高分級 aSAH[1-3] ，其病情重，病死率高，如果不及時采取相關(guān)治療措施，死亡率為 75%～100%[4-7] 。（剩余11883字）

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