开颅夹闭与血管内介入栓塞治疗颅内动脉瘤的临床疗效  

Clinical efficacy of craniotomy clipping and endovascular interventional embolization on intracranial aneurysm

作　　者：郭桐萁 臧培卓[1] 李付勇[1] 沈旭辉[1] 刘继辉[1] 王志超[1] GUO Tongqi;ZANG Peizhuo;LI Fuyong;SHEN Xuhui;LIU Jihui;WANG Zhichao(Department of Neurosurgery,the People's Hospital of China Medical University,Shenyang,Liaoning,110000,China)

机构地区：[1]中国医科大学人民医院神经外科,辽宁沈阳110000

出　　处：《当代医学》2022年第30期31-34,共4页Contemporary Medicine

摘　　要：目的探讨开颅夹闭与血管内介入栓塞治疗颅内动脉瘤的临床疗效。方法选取2019年1月至2020年12月本院收治的120例颅内动脉瘤破裂自发性脑出血患者作为研究对象,随机分为开颅组与介入栓塞组,每组60例。开颅组行开颅夹闭术治疗,介入栓塞组行血管内栓塞术治疗,比较两组手术及术后康复情况、脑损伤指标及并发症发生情况。结果术后,介入栓塞组手术时间和术后住院时间均短于开颅组,术中出血量少于开颅组,差异有统计学意义(P<0.05);术后6个月,介入栓塞组格拉斯哥预后评分表(GOS)评分为(1.82±0.42)分,低于开颅组的(2.46±0.41)分,差异有统计学意义(P<0.05)。术前,两组神经元特异性烯醇化酶(NSE)、S100B蛋白水平比较差异无统计学意义;术后,两组NSE、S100B蛋白水平均高于术前,但介入栓塞组低于开颅组,差异有统计学意义(P<0.05)。介入栓塞组并发症发生率为6.67%,显著低于开颅组的21.67%,差异有统计学意义(P<0.05)。结论与开颅夹闭术比较,血管内介入栓塞术创伤性更低,可减少术中出血量,有效避免手术导致的脑损伤,进一步提升外科治疗安全性和有效性。Objective To investigate the clinical efficacy of craniotomy clipping and endovascular interventional embolization in the treatment of intracranial aneurysm.Methods Atotal of 120 patients with spontaneous cerebral hemorrhage with ruptured intracranial aneurysm admitted to our hospital from January 2019 to December 2020 were selected as the research subjects,and they were randomly divided into craniotomy group and interventional embolization group,with 60 cases in each group.The craniotomy group was treated with craniotomy clipping,and the interventional embolization group was treated with endovascular interventional embolization,and the surgical and postoperative rehabilitation,brain injury indexes and complications of the two groups were compared.Results After surgery,the surgical time and postoperative hospital stay in the interventional embolization group were shorter than those in the craniotomy group,and the intraoperative blood loss was less than that in the craniotomy group,and the differences were statistically significant(P<0.05).After 6 moths after surgery,the score of the Glasgow prognostic score(GOS)in the interventional embolization group was(1.82±0.42)scores,which was significantly lower than(2.46±0.41)scores in the craniotomy group,and the difference was statistically significant(P<0.05).After surgery,the levels of euron-specific enolase(NSE)and S100B protein in the two groups were higher than those before surgery,and the levels of NSE and S100B protein in the interventional embolization group were lower than those in the craniotomy group,and the differencs were statistically significant(P<0.05).The complication rate in the interventional embolization group was 6.67%,which was significantly lower than 21.67%in the craniotomy group,and the difference was statistically significant(P<0.05).Conclusion Compared with craniotomy,endovascular interventional embolization is less traumatic,can reduces the intraoperative blood loss,effectively avoid brain injury caused by surgery,and further improve the saf

关 键 词：颅内动脉瘤 破裂 开颅夹闭术 血管内介入栓塞术 脑损伤 颅内感染 

分 类 号：R651.12[医药卫生—外科学]