关键词: 颅内动脉瘤, 破裂, 预后

Abstract: Objective  To investigate the influencing factors affecting the prognosis of ruptured intracranial aneurym surgery in the elderly patiens.
Methods  Seventy-four elderly patients with ruptured intracranial aneurysms were retrospectively analyzed. According to the Modified Rankin Scale(mRS) 6 months after surgery, 45 patients were divided into the good prognosis group(mRS 0-2 points) and 29 patients into the poor prognosis group(mRS 3-6 points). The influencing factors that may affect the prognosis of the surgery were analyzed.
Results  There were no significant differences in gender, hypertension, diabetes, coronary heart disease, smoking history, alcohol history, history of anti-platelet or anti-coagulation medications, history of cerebral hemorrhage, aneurysm site, multiple aneurysms, operation time, rebleeding, epilepsy, and severe symptoms of non-nervous system between the two groups(P＞0.05). The good prognosis group had lower proportion of patients with age ≥ 70 years old, Hunt-Hess grade Ⅲ-Ⅴ, frailty, timing of operation >3 days, aneurysm diameter ≥7 mm, cerebral ischemic stroke and hydrocephalus than the poor prognosis group, and the differences were statistically significant(P＜0.05 or P＜0.01). The Results   of multivariate Logistic regression analysis showed that Hunt-Hess grade, frailty, timing of operation and cerebral ischemic stroke could influence the prognosis, with statistically significant differences(P＜0.05). While age, aneurysm diameter and hydrocephalus had no effects on the prognosis, with no statistically significant differences(P＞0.05).
Conclusion  The prognosis of aneurysm surgery is affected by a number of factors. Hunt-Hess grade, risk score, timing of surgery and post-operative cerebral infarction are the important factors.

Key words: Intracranial , aneurysm, Craniotomy, Prognosis