老年人颅内动脉瘤外科治疗的临床研究

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1、老年人颅内动脉瘤外科治疗的临床研究【摘要】「【的研究老年颅内动脉瘤的临床治疗特点。方法回顾性分析67例60岁以上的颅内动脉瘤病人的临床资料。依据出院时GOS评分将预后分为良好（4〜5分）和差（1〜3分），分别探讨年龄、姓別、治疗手段（手术和介入）、术HUHunt-Hess分级、高血压史、冠心病史、动脉瘤部位、大小、数量等因素的影响。结果GOS评分预后良好50例，差17例。中位住院吋间手术治疗（19d）明显长于介入治疗（lid）,差异具有统计学意义（P<0.05）o单因素分析显示术前Hunt-Hess分级与预后相关（P<0.05）。多凶索的Lo

2、gistic冋归分析结果显示只有术前Hunt-Hess分级及动脉瘤部位与预后相关（P<0.05）,而与其他因素无关（P>0.05）。结论术前Hunt-Hess分级低（0〜2级）的老年动脉瘤效果良好，而高级别（3〜4级）死亡率和伤残率仍较高。动脉瘤部位是影响预后的重要因素。在本组病例中，手术和介入的治疗效果未见明显差异。【关键词】颅内动脉瘤老年人神经外科手术AclinicalresearchonthesurgeryofintracranialaneurysmsinelderlypatientsWANGFuyu,XUBainan,YUXingua

3、ng,etalDepartmentofNeurosurgery,GeneralHospitalofPLA,Beijing100853,ChinaAbstract:ObjectiveTostudytheclinicalcharacteristicsofintracranialaneurysmsinelderlypatients.MethodsClinicaldatafrom67patientsolderthan60yearswithintracranialaneurysmswereanalyzedretrospectively.Thepatie

4、nt'soutcomeatdischargeaccordingtotheGlasgowOutcomeScalewasdividedintotwocategories:favorable（4〜5grades）orunfavorable（1〜3grades）.Thosefactorsthatmightinflueneetheoutcomewereevaluated,includinggender,age,therapeutictool（opensurgeryorendovasculartreatment）,preoperativeHunt-Hes

5、sgrades,historyofhypertension,historyofcardiovasculardisease,location,sizeandnumberofaneurysms.ResultsGlasgowOutcomeScalewasfavorablein50casesandunfavorablein17cases.Themediantimeinhospitalfortheopensurgery（19days）wassignificantlylongerthanthatofendovasculartreatment（11days

6、）（P<（）.（）5）.ThepreoperativeHunt-Hessgradesandtheoutcomewasconsistentintheunivariableanalysis（P<0.05）.TheresultsofmultipleLogisticregressionanalysisshowedthatthepreoperativeHunt-Hessgradesandlocationofaneurysmswerecorrelativewiththeoutcome（P<0.05）.ConclusionTheelderlypatient

7、swithgoodHunt-Hessgrades（0〜2）havefavorableoutcome.However,inthosewithhighHunt-Hessgrades（3〜4）,morbidityandmortalityratesremainhigh.Thelocationofaneurysmsisimportantfactorfortheoutcome.Inourpatients,thereisnosignificantdifferenceinoutcomebetweenopensurgeryandendovasculartrea

8、tment.Keywords:intracranialaneurysms;aged;neurosurgicalprocedures脑血管病是常见病，也是老年人主要死