Effect of arachnoid plasty using fibrin glue membrane after clipping of ruptured aneurysm on the occurrence of complications and outcome in the elderly patients
Effect of arachnoid plasty using fibrin glue membrane after clipping of ruptured aneurysm on the occurrence of complications and outcome in the elderly patients
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DOI：
10.1007/s00701-006-0777-6
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发表时间：
2006-06-01
影响因子：
2.4
通讯作者：
Endo, S.
中科院分区：
文献类型：
--
作者：
Mino, Y.;Hirashima, Y.;Endo, S.
背景。老年动脉瘤性蛛网膜下腔出血（SAH）患者即使在动脉瘤手术后也容易出现血管痉挛、硬膜下积液和晚期脑积水等并发症。我们前瞻性地研究了老年患者动脉瘤破裂手术中使用纤维蛋白胶膜进行蛛网膜成形术预防并发症的效果。记录 SAH 后 3 个月对改良 Rankin 量表 (mRS) 和格拉斯哥结果量表 (GOS) 的影响。方法。从连续系列动脉瘤性 SAH 患者中选取 31 名年龄超过 70 岁的患者，交替分为两组，一组为蛛网膜成形术组（n = 16），另一组为未行蛛网膜成形术的对照组（n = 15）。进行统计分析以评估各种临床和神经放射学变量之间的关系，特别是蛛网膜成形术与症状性血管痉挛、硬膜下积液、晚期脑积水或发病后 3 个月的结果（如 mRS 和 GOS）之间的关系。结果。统计分析显示，蛛网膜成形术与晚期脑积水和硬膜下积液呈负相关，但在 SAH 后 3 个月时具有更好的 mRS。还注意到与较少发生的症状性血管痉挛相关的趋势。结论。使用纤维蛋白胶的蛛网膜成形术被认为可以有效预防 SAH 和动脉瘤手术相关的并发症。老年患者可以获得更好的结果。
Background. In elderly patients with aneurysmal subarachnoid hemorrhage (SAH), complications including vasosopasm, subdural effusion, and late hydrocephalus, are liable to occur even after aneurysmal surgery. We examined prospectively the efficacy of arachnoid plasty using fibrin glue membrane during surgery of ruptured aneurysms in the elderly patients for preventing complications. The effects on the modified Rankin scale (mRS) and the Glasgow outcome scale (GOS) 3 months after SAH were noted.Methods. Total of 31 patients aged more than 70 years selected from a consecutive series of patients with aneurysmal SAH, were divided into two groups alternately, a group with arachnoid plasty (n = 16) and a control group without arachnoid plasty (n = 15). Statistical analyses were performed to assess relationships among various clinical and neuroradiological variables, especially between arachnoid plasty and occurrence of symptomatic vasospasm, subdural effusion, late hydrocephalus, or outcome such as mRS and GOS 3 months after onset.Findings. Statistical analyses revealed that arachnoid plasty were associated with late hydrocephalus and subdural effusion negatively, but with better mRS at 3 months after SAH. A tendency to be associated with less frequent symptomatic vasospasm was also noted.Conclusion. Arachnoid plasty using fibrin glue is suggested to be effective in preventing complications associated with SAH and aneurysmal surgery. A better outcome in the elderly patients can be achieved.