颅内动脉瘤手术夹闭和血管内介入治疗的对比研究  

Comparative Study of Surgical Clipping and Endovascular Interventional Therapy for Intracranial Aneurysm

作　　者：张青松[1] 陈谦学[1] 周毅[2] 胡克琦[2] 彭鹏[2] 

机构地区：[1]武汉大学人民医院神经外科,武汉430060 [2]湖北文理学院附属医院,襄阳市中心医院神经外科,襄阳441021

出　　处：《中国医药导刊》2016年第10期1011-1013,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:对比颅内动脉瘤手术夹闭和血管内介入治疗的效果。方法:回顾性分析85例颅内动脉瘤患者的病历资料,40例患者采用手术夹闭治疗,45例采用血管内介入治疗,对比两组患者的预后状况、ADL和NIHSS评分、不良反应、住院时间和平均治疗时间。结果:手术夹闭组预后良好率85%,预后不良15%;血管内介入组预后良好率88.9%,预后不良11.1%,两组患者预后良好率及预后不良率差异无统计学意义(P>0.05)。手术夹闭组和血管内介入组发生动脉瘤再破、感染、脑积水、血管痉挛和腰椎穿刺术不良反应的几率差异较小,差异无统计学意义(P>0.05)。手术夹闭组治疗时间和住院时间高于血管内介入组,医疗费用低于血管内介入组,两组患者手术平均治疗时间、住院时间和医疗费用差异有统计学意义(P<0.05)。结论:手术夹闭和血管内介入治疗颅内动脉瘤的效果都较好,血管内植入支架和栓塞治疗可提高临床疗效。前循环动脉瘤和血管内介入治疗失败患者可首选手术夹闭治疗,复杂型和窄颈患者、不耐受手术及高龄患者可首选血管内介入治疗。Objective： The effects of surgical clipping and endovascular interventional therapy for intracranialaneurysms.Methods：A retrospective analysis was made on the clinical data of 85 cases of intracranial aneurysm patients,40 patients with surgical clipping treatment,45 cases were treated by endovascular interventional therapy, the prognosisof patients in the two groups were compared, ADL and NIHSS score, adverse reaction, hospitalization time and averagetime of treatment.Results：Surgical clipping group with good prognosis was 85% and 15% of poor prognosis; intravascularinterventional group with good prognosis was 88.9%, 11.1% of poor prognosis, the two groups of patients the rate ofgood and bad prognosis rate differences no statistical significance （P〉0.05）. Surgical clip closed group and vascularinterventional group, the incidence of aneurysm again broken, infection, hydrocephalus, cerebral vasospasm and lumbarpuncture, the adverse reaction probability of little difference, the difference was not statistically significant （P〉0.05）.Surgical clipping in the treatment group, the time and hospitalization time higher than that of intravascular interventionalgroup and medical costs lower than intravascular interventional group, the two groups of patients with operation averagetreatment time, hospitalization time, medical cost difference was statistically significant （P〈0.05）. Conclusion：Surgicalclipping and endovascular interventional treatment of intracranial aneurysms have better effect, the shorter operative time,shorter hospital stay and less economic burden. Clinical treatment should be combined with the specific circumstances of thepatient to choose the best treatment options, improve the operation, reduce the incidence of adverse reactions, improve thesurvival rate of patients.

关 键 词：手术夹闭 血管内介入 颅内动脉瘤 

分 类 号：R651.12[医药卫生—外科学]