开颅手术与支架辅助弹簧圈栓塞治疗颅内后循环动脉瘤的临床效果

Clinical effectiveness of stent-assisted embolization versus craniotomy for the posterior circulation aneurysms

目的对比开颅手术与支架辅助弹簧圈栓塞术对颅内后循环动脉瘤的治疗效果,探讨支架辅助弹簧圈栓塞术的安全性及有效性。方法回顾性分析2008-04～2012-06来我院就诊的颅内后循环动脉瘤患者102例,按照治疗方式的不同分为辅助组（行支架辅助弹簧圈栓塞术治疗）和开颅组（行开颅手术治疗）,比较两组手术用时、手术出血量、术后住院天数、术后格拉斯哥预后评分（GOS）、并发症发生率、复发率。结果辅助组、开颅组手术用时分别为（89.7±18.9）min、（136.2±26.1）min,手术出血量分别为（5.6±2.8）ml、（108.3±12.6）ml,术后住院天数分别为（13.6±2.5）d、（19.4±3.2）d,辅助组均少于开颅组,两组比较差异均有统计学意义（P〈0.05）。辅助组术后GOS评分明显高于开颅组（P〈0.05）;总并发症发生率为1.9%,复发率1.9%,与开颅组相比无明显差异（P＞0.05）。结论支架辅助弹簧圈栓塞术治疗具有手术用时短、出血少、术后恢复快、并发症发生率较低等优点,是一种安全有效的治疗方式,值得临床推广使用。

Objective To compare the clinical efficacy of stent-assisted embolization versus craniotomy for the posterior circulation aneurysms,and to explore the safety and efficacy of stent-assisted embolization. Methods From April 2008 to June 2012,the clinical data of 102 patients with posterior circulation aneurysms in our hospital were retrospectively analyzed. They were divided into observation group and control group according to the treatment method. The patients received stent-assisted embolization treatment in observation group and craniotomy treatment in control group. The clinical efficacy,surgical time,intraoperative blood loss,postoperative hospital stay were compared between the two groups. And the Glasgow outcome scale（GOS） was used to evaluate the therapeutic effect. Results The average surgical time was（89. 7 ± 18. 9） min and（136. 2 ± 26. 1） min in observation group and control group respectively; mean blood loss was（5. 6 ± 2. 8）ml and（108. 3 ± 12. 6）ml; mean postoperative hospital stay was（13. 6 ± 2. 5）d and（19. 4 ± 3. 2） d. The indicators mentioned above were significantly lower in observation group than in control group. The postoperative GOS score was higher in observation group than in control group（P 〈 0. 05）. The incidence of complications was 1. 9% and the recurrence rate was 1. 9% in observation group,and there was no significant difference between two groups（P 〉 0. 05）. Conclusion Stent-assisted coil embolization is a safe and effective way for aneurysm patients with shorter surgical time,less bleeding,faster recovery time and less complication.