电解可脱卸弹簧圈与显微手术夹闭治疗颅内破裂动脉瘤的临床疗效对比  

Comparison of clinical efficacy between guglielmi detachable coil and microsurgical clipping for treatment of ruptured intracranial aneurysms

作　　者：陆弘盈[1] 陆伟水[1] 覃重桥[1] 余松祚[1] 谭适[1] 张文佳[1] 周铭臻[1] 

机构地区：[1]广西医科大学第八附属医院暨贵港市人民医院神经外一科,贵港市537100

出　　处：《广西医学》2015年第11期1599-1601,1609,共4页Guangxi Medical Journal

摘　　要：目的对比电解可脱卸弹簧圈(GDC)与显微手术夹闭治疗颅内破裂动脉瘤的临床疗效。方法 33例颅内破裂动脉瘤患者,其中接受GDC栓塞治疗(栓塞组)14例,显微手术夹闭治疗(夹闭组)19例。比较两组临床疗效、动脉瘤闭塞效果、术后并发症发生率及术后住院时间。结果栓塞组预后良好9例、轻度残疾2例、重度残疾1例、植物生存1例、死亡1例,而夹闭组分别为10例、4例、2例、2例、1例,两组疗效比较,差异无统计学意义(P>0.05)。栓塞组动脉瘤完全闭塞率为64.3%(9/14),明显低于夹闭组的94.7%(18/19)(P<0.05)。栓塞组术后并发症发生率为7.1%(1/14),明显低于夹闭组的36.8%(7/19)(P<0.05),住院时间明显短于夹闭组(P<0.05)。结论 GDC与显微手术夹闭治疗颅内破裂动脉瘤的近期疗效相似,但GDC术后并发症发生率低,术后恢复快。Objective To compare the clinical efficacy between guglielmi detachable coil（ GDC） and microsurgical clipping for the treatment of ruptured intracranial aneurysms. Methods Of 33 patients with ruptured intracranial aneurysms,14 patients were treated with GDC embolization（ embolization group） and 19 patients with microsurgical clipping（ clipping group）. The clinical efficacy,efficacy of aneurysms obliteration,incidence of postoperative complications and postoperative hospital stay were compared between two groups. Results In the embolization group,the prognosis was good in 9 cases,mild disability occurred in 2 cases,severe disability in 1 case,vegetable survival in 1 case,and 1 case died. In the clipping group,the prognosis was good in 10 cases,mild disability occurred in 4 cases,severe disability in 2 cases,vegetable survival in 2 cases,and 1 case died. No statistical difference was observed in the clinical efficacy between two groups（ P 〉 0. 05）. The complete obliteration rate of aneurysms in the embolization group was significantly lower than that in the clipping group[64. 3%（ 9 /14） vs. 94. 7%（ 18 /19）,P 〈 0. 05]. The incidence of postoperative complications in the embolization group was significantly lower than that in the clipping group[7. 1%（ 1 /14） vs. 36. 8%（ 7 /19）,P 〈 0. 05]. The hospital stay in the embolization group was significantly shorter than that in the clipping group（ P 〈 0. 05）. Conclusion The short-term efficacy of GDC embolization is similar to that of microsurgical clipping,but GDC embolization obtains lower incidence of postoperative complications and faster postoperative recovery.

关 键 词：颅内破裂动脉瘤 电解可脱卸弹簧圈 显微手术夹闭 疗效 并发症 

分 类 号：R543.16[医药卫生—心血管疾病]