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目的 分析 75岁以上老年人脑动脉瘤破裂的手术治疗价值。 方法 回顾性分析 75岁以上老年人脑动脉瘤破裂 2 2例中 1 1例行显微外科手术治疗的结果。 结果 2 2例中 ,H &K ～ 级 1 0例 ,死亡 6例 ; ～ 级 1 2例 ,死亡 3例。早期手术的 1 1例中 ,术后恢复良好 4例 ,死亡 1例 ,病死率 9.1 %。其中 H &K ～ 级 5例 ,预后良好 2例、中残 2例、死亡 1例 ; ～ 级 6例 ,良好 2例、中残 2例、植物人生存 2例。总良好率 3 6.4 %。 1 1例非手术患者死亡 8例 ,病死率 72 .7%。 结论 术前临床分级及全身性疾病与患者预后密切相关。对 H &K ～ 级的 75岁以上老年脑动脉瘤破裂患者 ,早期直接显微手术夹闭脑动脉瘤是治疗脑动脉瘤破裂的首选方法 ,H &K ～ 级前循环脑动脉瘤破裂的患者只要不伴有严重的全身性疾病 ,手术治疗仍是挽救生命甚至达到良好恢复的方法。
Objective To analyze the value of surgical treatment of cerebral aneurysm rupture in the elderly over 75 years old. Methods We retrospectively analyzed the results of microsurgery in 11 of 21 patients with cerebral aneurysm rupture over the age of 75 years. Results Among 22 cases, there were 10 cases of H & K ~ grade, 6 cases of death; 12 cases of ~ class and 3 cases of death. Among the 11 cases of early operation, 4 cases recovered well after operation, 1 died and the case fatality rate was 9.1%. There were 5 cases with H & K ~ grade, 2 cases with good prognosis, 2 cases with moderate disability and 1 case died; 6 cases were in grade ~ 2 cases were good, 2 cases were disabled and 2 cases were vegetative. The overall good rate of 3 6.4%. One case of non-surgical patients died in 8 cases, the fatality rate was 72.7%. Conclusion Preoperative clinical grade and systemic disease are closely related to the prognosis of patients. For H & K-class patients with cerebral aneurysm rupture above 75 years of age, early direct microsurgical occlusion of cerebral aneurysm is the preferred method of treatment for ruptured cerebral aneurysm, as long as the H & K ~ class patients with anterior circulation aneurysm rupture With severe systemic disease, surgical treatment is still a way to save lives and even achieve good recovery.