高龄患者颅内破裂动脉瘤手术疗效及预后的相关因素分析

Analysis of the Factors Related to the Curative Effect of Operation and Prognosis of Elderly Patients with Ruptured Intracranial Aneurysms

目的探讨分析高龄患者颅内破裂动脉瘤手术疗效及预后的相关因素。方法回顾性分析该院2011年1月—2012年12月间收治的58例高龄(≥65岁)颅内破裂动脉瘤患者的临床资料,58例患者(58个动脉瘤)均行开颅夹闭治疗,观察手术疗效,分析影响预后的相关因素。结果 58例患者经开颅夹闭治疗,48例(82.76%)患者恢复良好,7例(12.07%)患者功能障碍,3例(5.17%)患者死亡。影响预后的相关因素主要为年龄、入院时的Hunt-Hess分级、高血脂症、Fisher分级、Glasgow评分,其中入院时的Hunt-Hess分级和高血脂症是影响预后的主要因素。结论高龄患者颅内破裂动脉瘤开颅夹闭手术疗效显著,值得推广应用。影响预后的相关因素相对复杂,入院时的Hunt-Hess分级和高血脂症起主要作用。

Objective To explore and analyze the factors related to the curative effect of operation and prognosis of elderly patients with ruptured intracranial aneurysms. Methods The clinical data of 58 cases of patients （~〉65 years old） with ruptured intracranial aneurysms admitted in our hospital from January, 2011 to December, 2012 were retrospectively analyzed. 58 cases （58 aneurysms） all received neurosurgical clipping. The curative effects were observed. And the factors affecting prognosis were analyzed. Results Of the 58 patients received neurosurgical clipping, 48 cases （82.76%） recovered well. Dysfunction occurred in 7 cases （12.07%）, 3 cases （5.17%） died. Related factors affecting the prognosis were age, Hunt-Hess Grade on admission, hyperlipidemia, Fisher Grade and Glasgow Score. The main factors affecting the prognosis were Hunt-Hess Grade on admission and hyperlipidemia. Conclusion For elderly patients with ruptured intracranial aneurysms, the effect of neurosurgical clipping is significant, and it is worthy of pro- motion and application. The related factors affecting the prognosis are relatively complex, Hunt-Hess Grade on admission and hy- perlipidemia are the main factors.