引用本文:钟 书,肖 泉,庞 刚,梁有明,蓝胜勇,叶 劲,刘若平,唐秀文,徐柯贝,唐玺和.开颅手术与血管内介入栓塞治疗颅内动脉瘤的疗效比较[J].中国临床新医学,2017,10(8):723-726.
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开颅手术与血管内介入栓塞治疗颅内动脉瘤的疗效比较
钟 书,肖 泉,庞 刚,梁有明,蓝胜勇,叶 劲,刘若平,唐秀文,徐柯贝,唐玺和
530021 南宁,广西壮族自治区人民医院神经外科
摘要:
[摘要] 目的 比较开颅显微手术和血管内介入栓塞治疗颅内动脉瘤的疗效。方法 收集2013-01~2016-01该院收治的颅内动脉瘤病例资料进行回顾性分析。按手术方法分为开颅手术组(48例)和介入栓塞组(51例),统计两组术后脑梗塞发生率、术后再出血情况及术后1个月患者的GOS评分,比较两组疗效。结果 介入栓塞组患者全部成功实施血管内介入治疗术。术后即刻造影结果显示,动脉瘤致密性栓塞40例,次全栓塞6例,部分栓塞2例。术后一个月回访结果显示,介入栓塞组GOS评分良好率为96.07%(评分≥4),开颅手术组良好率为83.33%,介入栓塞组高于开颅手术组,差异有统计学意义(P<0.05);术后脑梗塞发生率介入栓塞组为3.92%,开颅手术组为29.16%,差异有统计学意义(P<0.05);术后再出血发生率介入栓塞组为7.84%,开颅手术组为12.50%,介入栓塞组均低于开颅手术组,差异无统计学意义(P>0.05);术后复发率介入栓塞组为5.88%,开颅手术组为6.25%,差异无统计学意义(P>0.05)。结论 介入栓塞治疗颅内动脉瘤成功率高,手术并发症低,是一种安全、有效的颅内动脉瘤治疗术式。
关键词:  开颅显微手术  介入栓塞  颅内动脉瘤
DOI:10.3969/j.issn.1674-3806.2017.08.03
分类号:R 732.2+
基金项目:广西科学研究与技术开发计划项目(编号:桂科攻1355005-4-7)
Comparison of treatment effects on intracranial aneurysms between craniotomy and endovascular embolization
ZHONG Shu, XIAO Quan, PANG Gang, et al.
Comparison of treatment effects on intracranial aneurysms between craniotomy and endovascular embolization
Abstract:
[Abstract] Objective To compare the treatment effects on intracranial aneurysms between craniotomy and endovascular embolization.Methods We retrospectively analyzed the data on consecutive cerebral aneurysm patients treated in our department between January 2013 and January 2016. 48 patients were enrolled in the microsurgical clipping group and 51 patients in the intravascular embolization group. The occurrences of brain infraction and rebleeding were analyzed. The glasgow outcome scale(GOS) was assessed 1 month after the treatment.Results In the intravascular embolization group, complete occlusion was observed in 40 patients, subtotal occlusion in 6 patients, and incomplete embolizationin in 2 patients. The good outcome rate of the embolization group(GOS≥4 GOS)(96.07%) was higher than that of the microsurgical clipping group(P<0.05). The occurrences of infraction and rebleeding in the embolization group were lower than those in the microsurgical clipping group(P<0.05). There were no significant differenes in the recurrence rates between the two groups(P>0.05).Conclusion Endovascular embolization is a safe alternative treatment method for cerebral aneurysms.
Key words:  Craniotomy microsurgery  Interventional embolization  Intracranial aneurysm