颅内动脉瘤治疗的临床探讨(附126例报道)  

Analysis of treatment ways in 126 cases with intracranial aneurysms

作　　者：王治瑜[1] 唐振刚[1] 赵斌杰[1] 陈欣[1] 潘泰峰[1] 

机构地区：[1]湖北医药学院附属十堰市人民医院神经外科,湖北十堰442000

出　　处：《现代肿瘤医学》2013年第10期2215-2217,共3页Journal of Modern Oncology

摘　　要：目的:探讨血管内血栓法与显微手术夹闭法治疗颅内动脉瘤的临床疗效及适应证。方法:回顾分析从2005年-2011年期间经我院诊治的126例颅内动脉瘤患者的临床治疗资料。依据治疗方法的不同将126例患者分为A、B两组。A组为血管内栓塞治疗法,B组为显微手术治疗法。两组术后疗效均采用GOS评分标准进行评判,对评判结果采用列表并用秩和检验进行比较分析。结果:A组56例(共62个动脉瘤)中54例行弹簧圈栓塞,8例行支架置入加弹簧圈栓塞;术后恢复良好38例,中残9例,重残5例,死亡4例(动脉瘤破裂出血);B组70例均对动脉瘤进行手术夹闭,术后恢复良好63例,轻残3例,重残2例,死亡2例(死于大面积脑梗死)。两组疗效经秩和检验Z值为-8.364,P<0.05,差异具有显著性。结论:血管内血栓法与显微手术夹闭法治疗颅内动脉瘤各有优劣,整体上显微手术夹闭法的临床疗效优于血管内栓塞法,但在某些特殊部位、特殊情况的动脉瘤却更适合采用血管内栓塞治疗法。根据动脉瘤的位置、大小及本身情况合理的选择不同方法是取得满意疗效的关键。Objective：According to studying the curative effect and indications of the treatment of intracranial an- eurysms in two different ways of endovaseular embolization and microscopic surgical clipping, to sum up the experi- ence. Methods ：To analyze all the clinical documents of prognosis of 126 inpatients with intracranial aneurysms ,from the period of time 2005 -2011. According to the different ways of treatment, 126 cases were divided into two groups （group A for intravaseular embolization therapy, group B for mierosurgical treatment method）. The treatment efficacy of these two groups had been evaluated based on GOS score standards, and the evaluation results had been listed and compared by Wilcoxon rank - sum test. Results： In group A, all 56 patients （ totally 62 intraeranial aneurysms ）, who had accepted endovascular embolization,54 intracranial aneurysms had been conducted simplex endovascular emboli- zation,and 8 brackets ＋ endovascular embolization. According to GOS evaluating,42 patients had got very good re- covery, 16 patients with moderate disability,6 patients with serious disability, and 4 patients dead （die from rupture of the intracranial aneurysms）. While,in group B, all the 70 patients were conducted the treatment of craniotomy,63 got complete recovery, 3 minor disability, 2 serious disability, and 2 dead （die from large - scale cerebral infarction）. The therapeutic outcome of these two groups tested by the Wilcoxon rank - sum test,Z value was - 8. 364, and P 〈 0.05, there was significant difference of these data. Conclusion： Relatively speaking, the methods of endovascular emboliza- tion and microscopic surgical clipping of intraeranial aneurysms have their own advantages and disadvantages. From the overall point of view, the microscopic surgical clipping superiors to endovascular embolization, however, for some particular location of aneurysm and samples were more suitable for endovascular embolization therapy. Therefore, ac- cording to the aneurysmg location, size an

关 键 词：颅内动脉瘤 显微外科手术 介入治疗 血管内治疗 并发症 

分 类 号：R730.56[医药卫生—肿瘤]