摘要
目的比较开颅夹闭术与介入栓塞术治疗颅内微小动脉瘤的临床效果。方法选取自2013年2月至2017年1月宜宾市第二人民医院收治的150例颅内微小动脉瘤患者为研究对象。按随机数字表法将所有患者分为A组与B组,每组各75例。A组采用开颅夹闭术治疗; B组采用介入栓塞术。比较两组患者治疗效果,统计术中动脉瘤破裂发生情况及患者手术相关并发症发生率,采用格拉斯哥预后评分表(GOS)评定患者术后3个月短期预后情况,采用生活质量测定量表(QLQ-C30)评定患者手术前后生活质量的变化。结果 B组住院时间短于A组,两组比较,差异有统计学意义(P <0. 05)。B组脑血管痉挛发生率为16. 0%(12/75),显著高于A组的5. 3%(4/75),两组比较,差异有统计学意义(P <0. 05)。B组预后良好比例为96. 0%(72/75),显著高于A组的86. 7%(65/75),两组比较,差异有统计学意义(P <0. 05)。两组患者术后各维度评分均上升,且B组各维度评分均显著高于A组,两组比较,差异有统计学意义(P <0. 05)。结论开颅夹闭术与介入栓塞术治疗颅内微小动脉瘤均可获取较好的手术效果,但血管内介入栓塞微创,对机体创伤小,患者术后恢复速度快,生活质量高,但其手术难度高,学习曲线长,且脑血管痉挛发生风险大。
Objective To compare the clinical effects of neurosurgical clipping and interventional embolization in the treatment of intracranial tiny aneurysms. Methods A retrospective study was performed on 150 cases of patients with intracranial tiny aneurysms who were admitted from February 2013 to January 2017. Patients were randomly divided into the Group A and Group B,with 75 cases in each group. Patients in the Group A were treated by neurosurgical clipping,the others in the Group B were treated by interventional embolization. The therapeutic effects of the two groups were compared,and the incidence of intraoperative aneurysm rupture and the incidence of complications related to operation were statistically analyzed. The short-term prognosis in 3 months after operation was evaluated by the Glasgow Outcome Scale( GOS),and the quality of life was evaluated by the quality of life scale( QLQ-C30). Results The proportion of patients with good prognosis in Group B was 96. 0%( 72/75),significantly higher than 86. 7%( 65/75) in Group A( P < 0. 05). Postoperative scores of each dimension in Group B were higher than those in Group A( P < 0. 05). Conclusion Effect of neurosurgical clipping and interventional embolization are good in the treatment of intracranial tiny aneurysms. Endovascular interventional embolization is minimally invasive,the trauma is small,patients can recover fast after operation,and quality of life is high. However,the operation of the latter is difficult,the learning curve is long,and the risk of large cerebral vasospasm is high.
作者
刘文晶
张昌伟
王均
白亚强
张渊
许伟
LIU Wen-jing;ZHANG Chang-wei;WANG Jun;BAI Ya-qiang;ZHANG Yuan;XU Wei(Department of Neurosurgery,The Second People′s Hospital of Yibin,Yibin 644000,China)
出处
《临床军医杂志》
CAS
2019年第2期139-141,145,共4页
Clinical Journal of Medical Officers
基金
四川省科技计划项目(2016FZ0073)
关键词
颅内微小动脉瘤
开颅夹闭术
介入栓塞
动脉瘤破裂
Intracranial tiny aneurysm
Neurosurgical clipping
Interventional embolization
Aneurysm rupture
