| Objective:To investigate the practicable factors which have an influence on the prognosis of anterior circulating intraoperative aneurysm rupture (IAR), evaluate the prognostic value of different bleeding positions of IAR in patients, and to describe the technique that authors have used to clip the ruptured aneurysms. in the clipping operation.Methods:The clinical data of135patients with148aneurysms, treated with micro-neurosurgical techniques for clipping intracranial aneurysm from May,2009to March,2012, were retrospectively analyzed. Statistics analysis was performed to analyze the possible factors, such as age, gender, pre-op Hunt-Hess Scale, history of hypertension, size of aneurysm, volume of intraoperative blood loss (VIBL), application of temporary clip and different bleeding position.Results:31aneurysms of30patients ruptured (22.22%of aneurysms and20.95%of patients) during the operations. The outcome of patients were estimated by Glasgow outcome scale (GOS) by following up at1,3, and6months after surgery:94patients were5,23patients were4,9patients were3,2patients were2and8patients were1. Statistic analysis revealed that age(P=0.626, OR=2.667), gender(P=1.000, OR=1.185), size (P=1.000, OR=1.417), hypertension (P=0.336, OR=0.231), application of temporary clip (P=0.364, OR=2.667), time of temporary clip (P=0.490, OR=3.000)and VIBL (P=0.593, OR=1.882) are not the factors that influenced the prognosis of the operation with IAR, whereas pre-operative Hunt-Hess scale (P=0.009, OR=36.000) and different bleeding position (P=0.001, OR=100.00) have significant influence on it.Conclusion:Different bleeding positions has significant influence on the prognosis of patients with IAR, and the neck is the most devastating complication. Surgeons take appropriate measures according to different bleeding positions, the efficiency, accuracy and security of the operation will be improved. |
PDF Full Text Request