栓塞与夹闭对动脉瘤性蛛网膜下腔出血后脑血管痉挛的影响

Impact of ruptured cerebral aneurysm coiling and clipping on the incidence of cerebral vasospasm

目的探讨血管内栓塞术和动脉瘤夹闭术分别对动脉瘤性蛛网膜下腔出血后并发脑血管痉挛的影响。方法收集并分析2006年至2010年确诊为aSAH的患者。分别在发病72h内行栓塞或夹闭治疗100例临床资料。结果其中在栓塞组中发生临床CVS10例,而夹闭组中CVS19例。结论根据我们的研究,栓塞较夹闭可以减少CVS的发生率,缩短住院时间,但其对病死率未见明显影响。

Objective To assess the impact of treatment modality of aneurysmal subaraehnoid hemorrhage（aSAH） on the rate of vasospasm（VSP）. Methods 100 patients with aSAH admitted between 2006 and 2009 undergoing either endovascular coiling （EC） or surgical clipping （SC） within 72 hours of onset were analyzed . Clinical VSP was defined as neurological deficits unexplained by another etiology. Radiological VSP was defined based on transcranial Doppler （TCD） ultrasound, digital subtraction angiography （DSA）, and CT criteria. Bivariate and logistic regression analysis was used to determine VSP predictors. Results Of 100 patients, 45 （45%） underwent EC and 55 （55%） underwent SC. Clinical VSP was found in 22% of EC and 35% of SC patients. Mortality was similar in both groups however the LOS was longer in the SC patients. Conclusions Our study reveals that EC has a lower rate of VSP, shorter LOS, and comparable mortality to SC in aSAH.