血管内治疗与夹闭术治疗破裂性微小动脉瘤的比较

Comparison of endovascular treatment and clipping for patients with ruptured intracranial micro-aneurysm

目的分析破裂性微小动脉瘤的特点,评价夹闭术及血管内治疗的效果。方法对45例破裂性微小动脉瘤分别采用夹闭术(28例)和血管内治疗(17例),对两组患者并发症发生率、复发率及出院时格拉斯哥预后评分(GOS)进行比较。结果破裂性微小动脉瘤共45例,宽颈动脉瘤占84.44%。两组的并发症发生率的差异有统计学意义(P<0.05),复发率、术前Hunt-Hess分级及出院时GOS评分的差异均无统计学意义(P>0.05)。结论破裂性微小动脉瘤多为宽颈动脉瘤,动脉瘤夹闭术与血管内治疗均能达到良好效果。

Objective To analyze the characteristic of ruptured intracranial micro-aneurysm and evaluate outcomes of clipping and endovascular treatment.Methods 45 patients with ruptured intracranial micro-aneurysm received clipping（n=28） or endovascular treatment（n=17）.Their complications,recurrence rates and Glasgow outcome scale（GOS） scores at discharge were evaluated. Results There were 45 aneurysms,84.44% of which were wide-necked aneurysms.There was a statistical difference in the occurrence rate of complications（P0.05）,while there was no statistical difference in the recurrence rate,Hunt-Hess grade and GOS score（P0.05） between the clipping group and the endovascular treatment group.Conclusion Most ruptured intracranial micro-aneurysms are wide-necked aneurysms.Clipping and endovascular treatment are feasible methods to treat ruptured intracranial micro-aneuryam.