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年龄是否会影响未破裂脑动脉瘤患者的手术结果?来自日本单中心的一项为期2年的回顾性研究。

Does Age Affects the Surgical Outcome in Patients with Unruptured Cerebral Aneurysms? A 2-Year Retrospective Study from a Single Center in Japan.

作者信息

Duvuru Shyam, Sae-Ngow Treepob, Kato Yoko, Kawase Tsukasa, Yamada Yasuhiro, Tanaka Riki

机构信息

Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan.

出版信息

Asian J Neurosurg. 2018 Oct-Dec;13(4):1108-1111. doi: 10.4103/ajns.AJNS_151_17.

Abstract

BACKGROUND

The management of unruptured cerebral aneurysms (UCA) in elderly population is a challenge. With a very high life expectancy and high risk of rupture in Japan, the need for identifying the best treatment modality is essential to help the patients in decision-making.

METHODS

This was a 2-year single-center retrospective comparative analysis of the outcomes of surgical clipping (SC) in patients aged above 75 and <75 years. The modified Rankin score was used to stratify the patients and to analyze the functional outcome. Functional status at discharge was the primary end point.

RESULTS

There were 224 patients with 239 aneurysms. About 12.5% of the patients were more than 75 years with a mean age of 77.85. The mean age of patients <75 years was 60.96, and it was statistically significant. The overall male-to-female ratio was 1:3.3. The most common location was the middle cerebral artery followed by internal carotid artery at the posterior communicating and ophthalmic segments, and 22 patients had aneurysms of the posterior circulation. Nearly 77% of the aneurysms were <6 mm. There was no significant difference in size of the aneurysm as the age increased to more than 75 years. There were complications in 6 patients, and there was no mortality in the study population. There was no statistically significant difference in the outcome between the groups.

CONCLUSIONS

SC can be considered a safe option for UCA in the aging population.

摘要

背景

老年人群未破裂脑动脉瘤(UCA)的治疗是一项挑战。在日本,由于预期寿命非常高且破裂风险高,确定最佳治疗方式对于帮助患者进行决策至关重要。

方法

这是一项对75岁及以上和75岁以下患者手术夹闭(SC)结果进行的为期2年的单中心回顾性比较分析。采用改良Rankin量表对患者进行分层并分析功能结局。出院时的功能状态是主要终点。

结果

共有224例患者,239个动脉瘤。约12.5%的患者年龄超过75岁,平均年龄为77.85岁。75岁以下患者的平均年龄为60.96岁,具有统计学意义。总体男女比例为1:3.3。最常见的部位是大脑中动脉,其次是后交通段和眼段的颈内动脉,22例患者有后循环动脉瘤。近77%的动脉瘤直径小于6mm。随着年龄增加到75岁以上,动脉瘤大小无显著差异。6例患者出现并发症,研究人群中无死亡病例。两组之间的结局无统计学显著差异。

结论

对于老年人群的未破裂脑动脉瘤,手术夹闭可被视为一种安全的选择。

相似文献

7
Management of unruptured cerebral aneurysms.未破裂脑动脉瘤的管理
Neurol Res. 1996 Feb;18(1):39-44. doi: 10.1080/01616412.1996.11740375.

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