介入栓塞术与开颅术治疗脑动脉瘤临床疗效比较

Comparison of the effect of intervention embolization and operation in the treatment of cerebral aneurysms

目的比较介入栓塞术与开颅术治疗脑动脉瘤临床疗效。方法60例脑动脉瘤破裂的患者采用随机数字表法平均分为两组各30例，A组给予介入栓塞术治疗，B组给予开颅手术治疗。随访观察3个月，记录有无再出血，并采用Glasgow结果评分评价，同时检测治疗前后基质金属蛋白酶-2（MMP-2）水平变化及住院时间。结果治疗后，A组治疗总有效率73．4％、术后再出血率10．0％（3／30），B组分别为76．7％、6．7％（2／30），两组差异均无统计学意义（χ2=0．09、0．22，均P〉0．05）；两组治疗前MMP-2水平差异无统计学意义（t=1．21，P〉0．05）；两组手术治疗后3dMMp02水平分别为（20．1±8．7）μg/L、（35．7±8．9）μg/L，两组差异有统计学意义（t=3．33，P〈0．05）。A组住院时间（8．6±1．5）d，B组为（13．2±1．3）d，两组差异有统计学意义（t=3．18，P〈0．05）。结论对于脑动脉瘤破裂的患者，采用介入栓塞术治疗与开颅术疗效无明显差异，但可减少住院时问，且明显降低MMP-2水平。

Objective To compare of intervention embolization and operation in the treatment of brain aneu- rysms. Methods 60 cerebral aneurysm patients using random number table method were divided into two groups each 30 cases, group A given intervention embolization ; group B given surgical operation treatment. They were followed for 3 months, the bleed Glasgow results score, matrix metalloproteinases 2 （ MMP-2 ） level change and the length of time were recorded. Results After treatment, A group total effective rate was 73.4%, postoperative treatment to bleed a- gain rate was 10. 0% （3/30） ,B group was 76.7% ,6. 7% （2/30） ,two groups had no statistically significant differ- ences （χ2 = 0. 09,0.22, all P 〉 0.05 ） before treatment MMP-2 level between ;The two groups was statistically signifi- cant（t = 1.21 ,P〉0.05） ;Two groups after surgical treatment 3 d MMP-2 levels were（20. 1 ±8.7）μg//L, （35.7 ± 8. 9 ） μg//L respectively, which was statistically significant （ t = 3.33, P 〈 0.05 ）. A group of hospitalization time （ 8.6 ± 1.5 ）d, group B （13.2＋ 1.3 ）d, the difference between two groups was statistically significant （t = 3.18, P 〈 0.05 ）. Conclusion For brain aneurysm patients, the intervention embolization had no obvious difference in curative effect with operation, but could reduce the time in hospital and significantly reduced MMP-2 level.