开颅瘤颈夹闭手术治疗脑动脉瘤破裂患者的临床疗效观察  

Clinical Observation of Craniotomy and Neck Clipping in the Treatment of Ruptured Cerebral Aneurysms

作　　者：吴德骥 张春林 黄金生 陈文培 WU Deji;ZHANG Chunlin;HUANG Jinsheng;CHEN Wenpei(Nanping First Hospital Affiliated to Fujian Medical University,Nanping 353000,China)

机构地区：[1]福建医科大学附属南平第一医院,福建南平353000

出　　处：《中国医药指南》2021年第33期37-39,共3页Guide of China Medicine

摘　　要：目的探究行开颅瘤颈夹闭手术治疗脑动脉瘤破裂的临床疗效。方法选取2015年3月至2019年2月福建医科大学附属南平第一医院神经外科收治的180例脑动脉瘤破裂患者作为研究对象,按照不同的手术方式将所有研究对象分为两组,即对照组与观察组,每组90例。对照组所使用的手术方式为经股动脉血管内介入栓塞术,观察组所使用的手术方式为直接开颅行动脉瘤瘤颈夹闭手术,对两组手术前及手术后的各项指标,包括实验室指标、临床指标、疗效、并发症情况、术后复发等进行对比。结果观察组手术后红细胞计数、血清基质金属蛋白酶-2低于对照组(P<0.05);手术持续时间、总住院时间长于对照组,动脉瘤复发率低于对照组,差异有统计学意义(P<0.05);两组手术效果优良率和术后并发症发生率差异无统计学意义(P>0.05)。结论脑动脉瘤破裂后使用开颅夹闭动脉瘤瘤颈的方法效果显著,与血管内介入栓塞术式相比较,虽然治疗的时间有所延长,而且对实验室指标影响更明显,但并发症的发生风险并没有明显增加,对于远期预后来说,具有更低的复发率,临床上具有广泛推广意义及价值。Objective To explore the clinical effect of craniotomy and neck clipping in the treatment of ruptured cerebral aneurysms.Methods One hundred and eighty patients with ruptured cerebral aneurysms treated in the Department of Neurosurgery of Nanping First Hospital Affiliated to Fujian Medical University from March 2015 to February 2019 were selected as the research objects.According to different surgical methods,all the research objects were divided into two groups:control group and observation group,with 90 cases in each group.The operation method used in the control group was transcatheter arterial endovascular embolization,and the operation method used in the observation group was direct craniotomy and aneurysm neck clipping.The indexes before and after operation,including laboratory indexes,clinical indexes,curative effect,complications and postoperative recurrence,were compared between the two groups.Results The red blood cell count and serum matrix metalloproteinase-2 in the observation group were lower than those in the control group(P<0.05);the operation duration and total hospital stay were longer than those in the control group,but the recurrence rate of aneurysms was lower than that in the control group(P<0.05);there was no significant difference in the excellent and good rate of surgical effect and the incidence of postoperative complications between the two groups(P>0.05).Conclusion The effect of craniotomy clipping aneurysm neck after cerebral aneurysm rupture is significant.Compared with intravascular interventional embolization,although the treatment time is prolonged and the impact on laboratory indexes is more obvious,the risk of complications is not significantly increased,and it has a lower recurrence rate for long-term prognosis,It has extensive clinical significance and value.

关 键 词：开颅夹闭手术 血管内介入栓塞术 脑动脉瘤破裂 并发症发生率 

分 类 号：R739.41[医药卫生—肿瘤]