老年患者颅内动脉瘤破裂显微夹闭术的临床疗效分析

Clinical efficacy analysis of microsurgical clipping in treatment of ruptured intracraniai aneurysm in elderly patients

目的探讨显微夹闭手术治疗老年患者颅内动脉瘤破裂的疗效。方法选择2009年5月至2013年4月我院收治的颅内动脉瘤破裂老年患者150例，随机分为观察组和对照组，每组75例。观察组患者行显微外科夹闭手术进行治疗，对照组患者行血管内介人治疗，对两组患者的疗效、格拉斯哥预后评分（GOS）量表和术后并发症进行比较。结果观察组手术夹闭成功率为96．0％，高于对照组的闭塞成功率（78．7％），差异有统计学意义（χ2=13．54，P〈0．05）；观察组GOS量表的治愈率为80．0％，高于对照组（66．7％），差异有统计学意义（χ2=4．53，P〈0．05）；术后观察组患者的并发症发生率为9．3％，低于对照组（20．0％），差异有统计学意义（χ2=4．58，P〈0．05）。结论外科显微夹闭手术治疗老年患者颅内动脉瘤破裂具有夹闭成功率高、治愈率高、并发症少等优点，值得临床推广。

Objective To analyze the clinical efficacy of microsurgical clipping for the treatment of ruptured intracranial aneurysm in elderly patients. Methods 150 patients with ruptured intracranial aneurysms in our hospital from May 2009 to Apr 2013 were randomly divided into observation group and control group, with 75 cases in each group. The observation group was treated with microsurgical clipping, and the control group was treated with endovascular intervention. The efficacy, Glasgow outcome scale （GOS） and postoperative complications were compared between two groups. Results The success rate of microsurgical clipping was significantly higher in observation group than in the control group （96.0% vs. 78.70/00,χ2 =13.54, P〈0.05）. The cure rate of GOS scale was significantly higher in observation group than in the control group （80 % vs. 66.7%, χ2 = 4. 525, P〈0.05）. The incidence rate of postoperative complications was significantly lower in the observation group than in the control group （9.3% vs. 20.0%, χ2 = 4.58, P〈0.05）. Conclusions Microsurgical clipping for the treatment of ruptured intracranial aneurysm has the high success rate and cure rate, with fewer complications and lower medical costs, and is worthy of promotion.