手术夹闭和血管内介入治疗颅内宽颈动脉瘤的疗效比较  

Efficacy comparison of clipping and endovascular treatment for wide-necked intracranial aneurysms

作　　者：王卫[1,2] 王志刚[1] 丁璇[1] 王洪亮[2] 谢永胜[2] 

机构地区：[1]山东大学第二医院神经外科,济南250033 [2]武警山东总队医院神经外科,济南250014

出　　处：《山东大学学报（医学版）》2013年第4期55-58,共4页Journal of Shandong University:Health Sciences

基　　金：山东省科技计划项目(2008GG10002060)

摘　　要：目的探讨颅内宽颈动脉瘤不同治疗方法的疗效。方法回顾性分析2008年5月至2011年7月间手术夹闭和血管内介入治疗的146例、152个颅内宽颈动脉瘤,比较其术后疗效。预后采取改良mRS评分,0～2分为良好,3～6分为不良。结果手术夹闭90例患者94个动脉瘤,随访3～24个月(平均12.5个月),未见复发。其中完全夹闭92个,夹闭不全2个,予以再次手术夹闭,良好79例(87.8%)。血管内介入治疗56例、58个动脉瘤,随访6～96个月(平均36.2个月),复发8个(13.8%),良好50例(89.2%)。两组预后差异无统计学意义(P>0.05)。结论手术夹闭和血管内介入治疗均能有效治疗颅内宽颈动脉瘤。手术夹闭不易复发,血管内介入治疗相对容易复发。Objective To discuss the curative effects of treating wide-necked intracranial aneurysms with different methods. Methods We retrospective analyzed 146 patients with a total of 152 wide-necked intracranial aneurysms which underwent surgical clipping and endovascular treatment from May 2008 to July 2011. The postoperative effective- ness was compared. The modified Rankin Scale（mRS） was used to evaluate the outcome. The mRS score = 0-2 was defined as good outcome and the mRS score = 3-6 score was defined as poor outcome. Results 90 patients with 94 an- eurysms were treated with surgical clipping. The following-up results of 3 to 24 mohths （mean 12.5 months ）showed that there was no recurrence in all aneurysms. 92 aneurysms were clipped completely and 2 were clipped incompletely. The latter were clipped again. 79 patients （87.8%） had good outcome. 56 patients with 58 aneurysms underwent endovascu- lar treatment. The following-up results of 6 to 96 months （ mean 36.2 months） showed that 8 recurrence aneurysms （ 13.8% ）. 50 patients （89.2%） had good outcome. The outcome of the two groups did not differ significantly（P 〉 0.05 ）. Conclusion Both surgical clipping and endovascular treatment can treat wide-necked intracranial aneurysms ef- fectively. Lower recurrence was associated with surgical clipping, but higher recurrence was associated with endovascu- lar treatment in wide-necked intracranial aneurysms.

关 键 词：宽颈动脉瘤 手术夹闭 血管内介入治疗 预后 

分 类 号：R605[医药卫生—外科学]