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The Microsurgical Treatment of Intracranial Aneurysms and Analysis on the Factors Affecting Its’ Therapeutic

Author: MaJinLiang
Tutor: ZhuXiaoBo
School: Jilin University
Course: Clinical
Keywords: Intracranial aneurysms Microsurgery Efficacy Related factors Analysis
CLC: R651.12
Type: Master's thesis
Year: 2010
Downloads: 85
Quote: 1
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Abstract


Objective: To evaluate craniotomy microsurgical treatment of intracranial aneurysms and efficacy factors that may affect its efficacy analysis, thereby increasing intracranial aneurysm surgical treatment to improve the prognosis of patients quality of life. Summary intracranial aneurysm surgery patients experience. Methods: A retrospective analysis from January 2007 to October 2009 at the First Hospital of Jilin University, after two neurosurgeons CTA examination after surgical treatment of 143 cases of intracranial aneurysms in patients with clinical data. According to the aneurysm site, size and other factors combined with patient admission Hunt-Hess disease classification, CT Fisher grade, selection of cases for surgery, depending on patient selection of specific surgical approach, perioperative disposal, according to hospital discharge when the patient's prognosis GOS score of treatment effect analysis, the factors that may affect the surgery, such as Hunt-Hess grade, CT Fisher grade, timing of surgery, intraoperative rupture, aneurysm size, location, patient age, gender, postoperative psychosis factor by the SPSS 13.0 statistical software aneurysm may affect the prognostic factors by univariate analysis, multivariate regression analysis. Results: 143 patients with a total of 174 aneurysms were diagnosed through CTA, in which 171 aneurysms get surgical treatment, including complete occlusion of the aneurysm neck 117 cases, wrapped in 16 cases, 5 cases of occlusion plus package, isolated two cases set out ligation of two cases of aneurysm, pseudoaneurysm resection in 1 case. 143 cases were discharged, GOS prognostic score, 4 points and 5 points classified as good prognosis, good recovery 104 cases, accounting for 72.73%. 3 points or less for the poor prognosis. The group of 39 cases, accounting for 27.27%. Intraoperative aneurysm rupture six cases; this group of patients, 1 patient died postoperatively died of other diseases (multiple organ failure). Hunt-Hess grade (P = 0.000), CT Fisher grade (P = 0.000), postoperative complications (P = 0.000) and craniotomy microsurgical treatment of intracranial aneurysms significantly related to prognosis. Conclusions: 1) craniotomy microsurgical clipping of aneurysms proper treatment of intracranial aneurysms is an effective way. 2) craniotomy microsurgical treatment of intracranial aneurysms effect depends on the preoperative Hunt-Hess grade, CT Fisher grading and postoperative complications and other factors. The difference was statistically significant (P lt; 0.05). Which Hunt-Hess grade, postoperative complications are the main factors. To further define the various factors on the prognosis of intracranial aneurysms, to establish a more precise mathematical model, you need to do prospective analysis, increase the sample size, training someone to collect data.

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CLC: > Medicine, health > Surgery > Of surgery > Head and Neurosurgery > Brain > Cerebrovascular surgery
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