摘要
目的比较血管内介入栓塞与开颅手术夹闭治疗破裂颅内动脉瘤的疗效及安全性。方法选择2016年12月—2018年8月内蒙古医科大学附属医院神经外科急诊手术治疗破裂颅内动脉瘤患者78例作为研究对象,接受血管内介入栓塞治疗32例(血管介入组)、接受开颅手术夹闭治疗46例(开颅手术组)。比较2组患者的手术时间、住院时间及住院费用,围术期血清脑损伤指标[S100B蛋白(S100B)、神经元特异性烯醇化酶(NSE)]含量,术后并发症及格拉斯哥预后评分(GOS)差异。结果血管介入组患者的手术时间、住院时间短于开颅手术组患者,住院费用高于开颅手术组患者(t/P=8. 320/0. 000、10. 711/0. 000、12. 851/0. 000)。血管介入组术后6 h、24 h血清S100B、NSE的含量低于开颅手术组(6h:t/P=6.492/0.000、8.769/0.000;24 h:t/P=10.832/0.000、11.178/0.000)。2组患者脑血管痉挛、脑梗死、慢性脑积水等术后并发症发生率,GOS评分值的差异无统计学意义(P>0. 05)。结论血管内介入栓塞用于破裂颅内动脉瘤患者的治疗,在减小手术创伤、加速患者术后康复等方面具有优势,2种手术方式的术后并发症发生率相似。
Objective To compare the efficacy and safety of endovascular embolization and craniotomy clipping in the treatment of ruptured intracranial aneurysms. Methods From December 2016 to August 2018, 78 patients with ruptured intracranial aneurysms were treated by emergency neurosurgery in Affiliated Hospital of Inner Mongolia Medical University. 32 patients were treated by endovascular embolization(vascular intervention group) and 46 patients were treated by clipping craniotomy(craniotomy group). The operation time, hospitalization time and hospitalization expenses, the levels of serum brain injury indicators(S100 B, NSE), postoperative complications and Glasgow prognosis score(GOS) were compared between the two groups. Results In the vascular intervention group, the operation time and hospitalization time were shorter than those in the craniotomy group. The hospitalization cost was higher than that in the craniotomy group(t/P = 8. 320/0. 000,t/P=10.711/0.000, t/P=12.851/0.000). The levels of serum S100 B and NSE in the vascular intervention group were lower than those in the craniotomy group at 6 h and 24 h after surgery(6 h: t/P =6.492/0. 000, t/P= 8. 769/0. 000;24 h: t/P=10.832/0.000, t/P=11. 178/0.000). There were no significant differences in the incidence of postoperative complications and GOS scores between the two groups(P >0. 05). Conclusion Intravascular interventional embolization for the treatment of ruptured intracranial aneurysms has advantages in reducing surgical trauma and speeding up the recovery of patients. The incidence of complications of the two surgical methods is similar.
作者
苏优勒
张占普
窦长武
朝博
黄平
李昊
SU Youle;ZHANG Zhanpu;DOU Changwu;CHAO Bo;HUANG Ping;LI Hao(Department of Neurosurgery,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China)
出处
《疑难病杂志》
CAS
2019年第5期455-458,463,共5页
Chinese Journal of Difficult and Complicated Cases
基金
内蒙古自治区科技厅面上项目(2013MS1139)
关键词
破裂颅内动脉瘤
血管内介入栓塞
开颅手术夹闭
疗效
安全性
Ruptured intracranial aneurysm
Endovascular interventional embolization
Craniotomy clipping
Therapeutic effect
Safety
