【摘要】 目的：探究导致前交通动脉（ACo A）瘤破裂夹闭术后发生慢性脑积水的因素。方法：回顾性分析2022年1月—2025年1月南阳市中心医院收治的121例ACo A瘤破裂患者临床资料。所有患者均接受夹闭术治疗，观察术后发生慢性脑积水的情况。将发生慢性脑积水的患者纳入发生组，将未发生慢性脑积水的患者纳入未发生组。比较两组一般资料。使用Logistic回归方程分析差异有统计学意义的一般资料，确定导致ACo A瘤破裂夹闭术后发生慢性脑积水的因素。结果：121例ACo A瘤破裂患者术后有18例发生慢性脑积水，占比为14.88%；有103例未发生慢性脑积水，占比为85.12%。发生组年龄大于未发生组，有吸烟史患者占比高于未发生组，出血次数多于未发生组，Hunt-Hess分级、改良Fisher分级高于未发生组，有脑室积血患者占比高于未发生组（P<0.05）。年龄大、有吸烟史、出血次数多、Hunt-Hess分级高、改良Fisher分级高、有脑室积血均为ACo A瘤破裂患者夹闭术后发生慢性脑积水的独立危险因素（P<0.05）。结论：导致ACo A瘤破裂患者夹闭术后发生慢性脑积水的因素较多，包括年龄大、有吸烟史、出血次数多、Hunt-Hess分级高、改良Fisher分级高、有脑室积血，临床应对存在上述因素的患者加强预防措施，避免预后不良的情况。更多还原

【Abstract】 Objective: To investigate the factors leading to chronic hydrocephalus after clipping surgery for ruptured anterior communicating artery(ACoA) aneurysm. Methods: A retrospective analysis was conducted on the clinical data of 121 patients with ruptured ACoA aneurysm admitted to Nanyang Central Hospital from January 2022 to January 2025. All patients underwent clipping surgery, and the occurrence of postoperative chronic hydrocephalus was observed. Patients who developed chronic hydrocephalus were included in the occurrence group, and those who did not were included in the non-occurrence group. General data were compared between the two groups. Logistic regression analysis was used to identify general data with statistically significant differences, so as to determine the factors leading to chronic hydrocephalus after clipping surgery for ruptured ACoA aneurysm. Results: Among the 121 patients with ruptured ACo A aneurysm, 18 developed chronic hydrocephalus after surgery, accounting for 14.88%; 103 did not develop chronic hydrocephalus, accounting for 85.12%. The occurrence group had older age, a higher proportion of patients with a smoking history, more bleeding episodes, higher Hunt-Hess grade and modified Fisher grade, and a higher proportion of patients with intraventricular hemorrhage compared with the non-occurrence group(P < 0.05). Advanced age, smoking history, more bleeding episodes, high Hunt-Hess grade, high modified Fisher grade, and intraventricular hemorrhage were independent risk factors for chronic hydrocephalus after clipping surgery in patients with ruptured ACoA aneurysm. Conclusion: There are multiple factors leading to chronic hydrocephalus after clipping surgery for patients with ruptured ACo A aneurysm, including advanced age, smoking history, more bleeding episodes, high Hunt-Hess grade, high modified Fisher grade, and intraventricular hemorrhage. Clinically, enhanced preventive measures should be implemented for patients with these factors to avoid poor prognosis.更多还原