夹闭术与栓塞术治疗前循环动脉瘤短期疗效及对神经功能的影响  

The difference of short-term curative effect between clipping and embolization in the treatment of anterior circulation aneurysms and influence on the nerve function

作　　者：王育胜[1] 陈泽鑫[1] 洪映标[1] 蔡洁波[1] 彭晖[1] 蔡跃豪[1] WANG Yusheng;CHEN Zexin;HONG Yingbiao;CAI Jiebo;PENG Hui;CAI Yuehao(Jieyang People’s Hospital,Jieyang 522000,China)

机构地区：[1]揭阳市人民医院,广东揭阳522000

出　　处：《中国实用神经疾病杂志》2021年第1期42-48,共7页Chinese Journal of Practical Nervous Diseases

基　　金：揭阳市医学科学技术研究项目(编号:揭市卫[2019]66号-18)。

摘　　要：目的比较夹闭术与栓塞术治疗前循环动脉瘤患者的短期疗效及对神经功能的影响。方法选取2019-02—2020-06揭阳市人民医院62例前循环动脉瘤患者,其中2019-02—2019-10行夹闭术患者31例为夹闭术组,2019-11—2020-06行栓塞术患者31例为栓塞术组。比较2组手术的疗效、住院时间、住院费用、生活质量。随访3个月~1 a,比较2组预后和并发症发生率。结果栓塞术组手术和住院时间小于夹闭术组,栓塞术组住院费用、生活质量高于夹闭术组(P<0.05)。栓塞术组预后良好93.55%,预后差3.23%,死亡3.23%;夹闭术组预后良好90.32%,预后差6.45%,死亡3.23%。夹闭术组和栓塞术组格拉斯哥预后分级(GOS)差异无统计学意义(P>0.05)。栓塞术组脑梗死发生率6.45%,脑血管痉挛发生率35.48%,脑积水发生率32.26%,总发生率70.97%;夹闭术组脑梗死发生率3.23%,脑血管痉挛发生率41.34%,脑积水发生率19.35%,总发生率64.52%;夹闭术组和栓塞术组并发症发生率差异无统计学意义(P>0.05)。结论夹闭术和栓塞术治疗前循环动脉瘤的短期疗效相当,但栓塞术手术时间、住院时间短,对脑组织损伤较小,治疗费用较高。根据有无禁忌证、对开颅手术接受程度选择合适的手术方式进行个体化治疗。Objective To compare the short-term curative effects of clipping and embolization in the treatment of patients with anterior circulation aneurysms and the effects on neurological function.Methods A total of 62 patients with anterior circulation aneurysms from February 2019 to June 2020 were selected.From February 2019 to October 2019,31 patients who underwent clipping surgery were in the clipping group,and 31 patients who underwent embolization from November 2019 to June 2020 were in the embolization group.The operation and hospitalization time,hospitalization expenses and quality of life were compared between the two groups.Follow-up was 3 months to 1 year to compare the prognosis and complication rate between the two groups.Results The operation and hospital stay in the embolization group were shorter than those in the clipping surgery group,and the hospitalization cost and quality of life in the embolization group were higher than those in the clipping surgery group(P<0.05).The embolization group had a good prognosis of 93.55%,a poor prognosis of 3.23%,and a death 3.23%;the clipping group had a good prognosis of 90.32%,a poor prognosis of 6.45%,and a death of 3.23%.There was no significant difference in Glasgow outcome scale(GOS)between the clipping group and the embolization group(P>0.05).In the embolization group,the incidence of cerebral infarction was 6.45%,the incidence of cerebral vasospasm was 35.48%,the incidence of hydrocephalus was 32.26%,and the total incidence was 70.97%;the incidence of cerebral infarction in the clipping group was 3.23%,and the incidence of cerebral vasospasm was 41.34%.The incidence of hydrocephalus was 19.35%,and the total incidence was 64.52%;there was no significant difference in the incidence of complications between the clipping group and the embolization group(P>0.05).Conclusion Clipping and embolization had the same short-term curative effect on anterior circulation aneurysms.However,the embolization operation,hospitalization time is short,the brain tissue damage was smal

关 键 词：动脉瘤 前循环 夹闭术 栓塞术 组织损伤 神经功能 

分 类 号：R739.41[医药卫生—肿瘤]