开颅夹闭与血管介入栓塞术治疗老年脑动脉瘤患者的临床作用比较探讨  

Comparison of Clinical Effects between Craniotomy and Vascular Interventional Embolization in the Treatment of Elderly Patients with Cerebral Aneurysms

作　　者：季家璇 王志荣 JI Jiaxuan;WANG Zhirong(Department of Neurosurgery,Zhangjiagang Hospital of Traditional Chinese Medicine,Zhangjiagang,Jiangsu Province,215600 China;Department of Orthopedics,Zhangjiagang Hospital of Traditional Chinese Medicine,Zhangjiagang,Jiangsu Province,215600 China)

机构地区：[1]张家港市中医医院神经外科,江苏张家港215600 [2]张家港市中医医院骨科,江苏张家港215600

出　　处：《中外医疗》2021年第28期25-28,共4页China & Foreign Medical Treatment

基　　金：省级课题:基于"内分泌-骨轴"调控骨改建防治关节置换术后早期假体周围丢失策略的建立及临床研究(BE2020666)。

摘　　要：目的对比开颅夹闭与血管介入栓塞术治疗老年脑动脉瘤患者的临床效果。方法方便选取2017年1月—2020年1月在该院进行手术治疗的老年脑动脉瘤患者72例作为研究对象,依据手术方案的不同将患者分为A组(开颅夹闭治疗组)36例和B组(血管介入栓塞术治疗组)36例,对比分析两组患者手术时间、住院时间、住院费用、手术相关并发症发生情况、术后3个月神经功能恢复情况及术后1年预后情况。结果B组患者手术时间及住院时间均短于A组,差异有统计学意义(t=6.096、11.448,P<0.05),A组患者住院费用明显低于B组,差异有统计学意义(t=20.664,P=0.001);B组患者术后并发症发生率为16.67%,明显低于A组患者的38.89%,差异有统计学意义(χ^(2)=4.431,P=0.035);术后3个月,两组患者NIHSS评分较术前均明显降低,B组患者NIHSS评分明显低于A组患者,差异有统计学意义(t=10.283,P=0.001);术后对患者进行为期1年的随访,B组患者恢复良好率显著高于A组患者,差异有统计学意义(Z=12.013,P=0.044)。结论血管介入栓塞术治疗老年脑动脉瘤患者的近期效果及远期效果均明显优于开颅夹闭术,手术治疗时间更短,患者术后恢复快,能够减少患者住院周期,减轻患者神经功能缺损程度,改善患者的预后,且术后并发症少,安全性更高,虽然治疗费用相对较高,但总体分析血管介入栓塞术适用性更广泛。Objective To compare the clinical effects of craniotomy and vascular interventional embolization in the treatment of elderly patients with cerebral aneurysms.Methods From January 2017 to January 2020,72 elderly patients with cerebral aneurysm undergoing surgical treatment in the hospital were conveniently selected as study objects,and the patients were divided into group A(craniotomy and clipping treatment group according to different surgical plans)36 cases and group B(vascular interventional embolization treatment group)36 cases,comparative analysis of the operation time,hospitalization time,hospitalization expenses,the occurrence of surgery-related complications,the recovery of neurological function in the 3 months after the operation,and the operation 1 year prognosis.Results The operation time and hospitalization time of group B were shorter than those of group A,the difference was statistically significant(t=6.096,11.448,P<0.05).The hospitalization cost of group A was significantly lower than that of group B,the difference was statistically significant(t=20.664,P=0.001).The postoperative complication rate of patients in group B was 16.67%,which was significantly lower than 38.89%of patients in group A,the difference was statistically significant(χ^(2)=4.431,P=0.035);3 months after operation,the NIHSS scores of the two groups were lower than those before the operation,the NIHSS score of group B patients was significantly lower than that of group A patients,the difference was statistically significant(t=10.283,P=0.001);the patients were followed up for one year after the operation,and the recovery rate of group B patients was ignificantly higher than that of group A,the difference was statistically significant(Z=12.013,P=0.044).Conclusion The short-term and long-term effects of vascular interventional embolization in the treatment of elderly patients with cerebral aneurysms are significantly better than craniotomy and clipping.The surgical treatment time is shorter,and the patient recovers quickly after surg

关 键 词：开颅夹闭 血管介入栓塞术 老年脑动脉瘤患者 临床作用 

分 类 号：R248[医药卫生—中医临床基础]