显微开颅夹闭术与血管内栓塞术治疗颅内前循环动脉瘤的效果比较  

Comparison of the Effects of Microscopic Craniotomy Clipping and Endovascular Embolization in the Treatment of Intracranial Anterior Circulation Aneurysms

作　　者：罗杰[1] 周帆[1] 黄云峰[1] 袁金刚 陈风 李帆 LUO Jie;ZHOU Fan;HUANG Yunfeng;YUAN Jingang;CHEN Feng;LI Fan(Central Hospital of Huanggang,Huanggang 438000,China;不详)

机构地区：[1]黄冈市中心医院,湖北黄冈438000 [2]麻城市白果中心卫生院

出　　处：《中外医学研究》2021年第29期171-174,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:比较显微开颅夹闭术与血管内栓塞术治疗颅内前循环动脉瘤的效果。方法:回顾性分析黄冈市中心医院神经外科2017年2月-2019年6月行手术治疗的74例颅内前循环动脉瘤患者的病历资料。根据手术方式不同分为显微开颅夹闭组(37例)和血管内栓塞组(37例)。比较两组手术操作时间、术中出血量、术后恢复时间等相关指标;比较两组术后精神障碍、局灶性神经功能障碍、脑积水、动脉瘤破裂和脑血管痉挛等并发症发生率及复发率;采用格拉斯哥预后评分(GOS)判断两组疗效。结果:血管内栓塞组手术操作时间和术后住院时间均短于显微开颅夹闭组,术中出血量少于显微开颅夹闭组,差异有统计学意义(P<0.05);显微开颅夹闭组良好率为67.57%,血管内栓塞组良好率为59.46%,差异无统计学意义(P>0.05);血管内栓塞组术后精神障碍、局灶性神经功能障碍、脑积水、动脉瘤破裂和脑血管痉挛等并发症发生率低于显微开颅夹闭组,差异有统计学意义(P<0.05);而血管内栓塞组复发率高于显微开颅夹闭组,差异有统计学意义(P<0.05)。结论:显微开颅夹闭术与血管内栓塞术治疗颅内前循环动脉瘤的效果相似,但血管内栓塞术可有效减少术中出血量,缩短手术时间和术后住院时间,且并发症发生率较低,但复发率较高,临床应根据患者需求,同时结合病情制定最适宜的手术治疗方案。Objective:To compare the effect of microscopic craniotomy clipping and endovascular embolization in the treatment of intracranial anterior circulation aneurysms.Method:The medical records of 74 patients with intracranial anterior circulation aneurysms who underwent surgical treatment in the department of neurosurgery of Huanggang Central Hospital from February 2017 to June 2019 were retrospectively analyzed.They were divided into microscopic craniotomy clipping group(37 cases)and endovascular embolization group(37 cases)according to different surgical methods.The operation-related indexes such as operation time,intraoperative blood loss,postoperative recovery time between the two groups were compared.The incidence of postoperative complications such as mental disorder,focal neurological dysfunction,hydrocephalus,aneurysm rupture,cerebral vasospasm and the recurrence rate between the two groups were compared.The efficacy of the two groups were evaluated by GOS.Result:The operation time and postoperative hospitalization time of the endovascular embolization group were shorter than those of the microscopic craniotomy clipping group,and the intraoperative blood loss was less than that of the microscopic craniotomy clipping group,and the differences were statistically significant(P<0.05).The good rate of microscopic craniotomy clipping group was 67.57%,and the good rate of endovascular embolization group was 59.46%,and the difference was not statistically significant(P>0.05).The incidence of postoperative complications such as mental disorder,focal neurological dysfunction,hydrocephalus,aneurysm rupture and cerebral vasospasm of endovascular embolization group were lower than those of microscopic craniotomy clipping group,and the difference was statistically significant(P<0.05).But the recurrence rate of endovascular embolization group was higher than that of microscopic craniotomy clipping group,and the difference was statistically significant(P<0.05).Conclusion:Microscopic craniotomy clipping and endovascular emboli

关 键 词：显微开颅夹闭术 血管内栓塞术 颅内前循环动脉瘤 

分 类 号：R651.12[医药卫生—外科学]