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Objective To study the factors affecting the prognosis of intracranial aneurysm operation for elderly patients. Methods Thirty elderly patients (≥60 years old) with intracranial aneurysm who were treated surgically were evaluated retrospectively. The factors that might affect the result of operation were analyzed by slng]e-factor and multi-factor. Result The factors that had significant correlation with the prognosis were Hunt-Hess grade,location of aneurysm,surgical timing (P =0.007,0.019,0.007).Conclusion The prognosis of intracranial aneurysm operation for elderly patients is affected by many factors,age is not a contraindication to aneurysm operation,early aneurysm operation treatment is suggested for elderly patients.
ABSTRACT
BACKGROUND:At present,autogenous periosteum and artificial dura mater are usually applied as the substitute grafts for the dural defect by neurological surgery.However they do not accord with the developing trend of modern medicine,due to the limitations of material size and shape,operational complex and additional wound.OBJECTIVE:To observe and compare the evolution of a new type bio-artificial dura and autogenous periosteum in replacing orthotopic duraDESIGN:Controlled observation and trial.SETTING:Animal Testing Center in the 157 Hospital of Guangzhou City.MATERIALS:Nine New Zealand rabbits.aged 6 months and weighed 2-3 kg,either gender was selected.Twelve hybrid healthy dogs of both genders,aged 2 years and weighed 15-20 kg.New type dura mater(No.2006.3460627).METHODS:The experiment was carried out at the Animal Testing Center in the 157 Hospital of Guangzhou City from October 2003 to October 2005.After the general anesthesia and bilateral craniotomy,the bilateral dural defect and pia mater injury were induced partly,then dural neoplasty was performed using new type artificial dura and autogenous periosteum.MAIN OUTCOME MEASURES:At months 1,6,12 of modeling,each three rabbits were selected to isolate and expose the implanted materials,while each four dogs were selected at months 6,12,24 of modeling,died of disease or prior to death.General observation and microscopic assessment of samples were compared to analyze the development of implanted materials at difference stages.RESULTS:Except one experimental dog died during the anesthesia,9 rabbits and 11 dogs were involved in the final presented the extemal surface of adherence and separation with pedcranium,grew well with surrounding orthotopic dura.For the internal surface of materials,the new type artificial dura was more likely the orthotopic dura and did no adhere to pericranium, and filament-shaped adherence appeared occasionally, while there were filament-shaped even month 12 of grafting new type artificial dura into the experimental rabbits.inflammatory cellular reactions such as neutrophil and lymphocyte were not found,additionally no capsule wall formation occurred.The internal surface of artificial dura was covered with epithelial cells,which appeared fibroplasia,fibroblast proliferation,degradation of implants and obvious reduction of total cell amount.Moreover the blood capillary was also found.CONCLUSION:New type artificial dura can achieve the dural reconstruction through producing epithelial cells and being nibbled.degraded and substituted by autogenous tissue.And no adherence to cerebral tissues is found.New type artificial dura is superior to autogenous periosteum for repairing the dural defects.