早期显微手术夹闭瘤颈及介入栓塞治疗前循环脑动脉瘤破裂出血效果比较  

Comparison of the Effect of Early Microsurgery to Close the Tumor Neck and Interventional Embolization for the Treatment of Ruptured and Hemorrhage of Anterior Circulation Cerebral Aneurysm

作　　者：钱中琪[1] 丁绪元[1] 杨少峰[1] 刘大军[1] QIAN Zhong-qi;DING Xu-yuan;YANG Shao-feng;LIU Da-jun(Department of Neurosurgery,Taizhou Second People's Hospital,Taizhou,Jiangsu Province,225500 China)

机构地区：[1]泰州市第二人民医院神经外科,江苏泰州225500

出　　处：《中外医疗》2020年第32期79-81,共3页China & Foreign Medical Treatment

摘　　要：目的探讨早期显微手术夹闭瘤颈治疗前循环动脉瘤(ACA)的临床疗效。方法方便筛选2015年1月—2019年10月该院收治的58例ACA病例并随机分组,A组实施早期显微开颅术夹闭瘤颈治疗,B组介入栓塞治疗。对比两组GOS、术后并发症情况;随访2个月,比较手术前后两组存活患者NIHSS、ADL评分。结果 A组患者GOS良好率96.67%高于B组78.57%,差异有统计学意义(χ~2=4.468,P<0.05);A组并发症发生率10.00%低于B组32.14%,差异有统计学意义(χ~2=4.327,P<0.05)。手术前,两组存活者NIHSS、ADL评分对比,差异无统计学意义(P>0.05);术后随访2个月,A组NIHSS、ADL评分(14.15±4.23)分、(68.24±6.52)分与术前相比差异有统计学意义(P<0.05);B组NIHSS、ADL评分分别为(20.34±5.56)分、(57.45±5.82)分与术前相比差异有统计学意义(P<0.05);两组间比较,差异有统计学意义(t=4.519、6.126,P<0.05)。结论显微手术夹闭瘤颈治疗前循环动脉瘤效果好,相较于血管内介入栓塞来说,短期预后更好,更能减少多种术后并发症,提高患者生活质量。Objective To observe the clinical effect of early microsurgical clamping of the tumor neck in the treatment of anterior circulating aneurysm(ACA).Methods Fifty-eight cases of ACA treated in the hospital from January 2015 to October 2019 were conveniently selected and randomly divided into groups.Group A underwent early microcraniotomy to clamp the tumor neck and group B underwent embolization.GOS and postoperative complications were compared between the two groups.Follow-up for 2 months was used to compare the NIHSS and ADL scores of surviving patients before and after surgery.Results The GOS good rate of group A was 96.67%higher than that of group B 78.57%,the difference was statistically significant(χ2=4.468,P<0.05);the complication rate of group A was 10.00%lower than that of group B 32.14%,the difference was statistically significant(χ2=4.327,P<0.05).Before surgery,the comparison of NIHSS and ADL scores of the two groups of survivors was not statistically significant(P>0.05);after 2 months of follow-up,the NIHSS and ADL scores of group A were(14.15±4.23)points and(68.24±6.52)points.Compared with preoperatively,the difference was statistically significant(P<0.05);NIHSS and ADL scores in group B were(20.34±5.56)points and(57.45±5.82)points compared with preoperatively,the difference was statistically significant(P<0.05);The difference between the two groups was statistically significant(t=4.519,6.126,P<0.05).Conclusion Microsurgical clamping of the aneurysm neck for anterior circulation aneurysms is effective.Compared with endovascular embolization,the short-term prognosis is better,and it can reduce a variety of postoperative complications and improve the quality of life of patients.

关 键 词：早期显微手术 夹闭瘤颈 前循环动脉瘤 

分 类 号：R651.12[医药卫生—外科学]