大脑中动脉动脉瘤介入栓塞与手术夹闭的疗效对比研究

Comparison of clinical efficacy and prognosis between embolization and surgical clipping in treatment of middle cerebral artery aneurysm

目的比较大脑中动脉动脉瘤(MCAA)介入栓塞与手术夹闭的疗效及预后。方法选择45例MCAA动脉瘤患者,随机分成A、B组,A组患者采取介入栓塞,B组采用开颅夹闭,观察2组疗效,评价预后。结果术后第3日,A组患者GCS评分高于B组、血管痉挛程度低于B组(P<0.05),第7、14日2组患者的GCS评分、血管痉挛程度比较差异无统计学意义(P>0.05)。术后第30日,2组患者的改良Rankin量表评分比较差异无统计学意义(P>0.05)。结论采用介入栓塞与手术夹闭治疗MCAA远期疗效相近,但介入栓塞起效较快。

Objective To compare the clinical efficacy and prognosis between embolization and sur-gical clipping in treatment of middle cerebral artery aneurysm （MCAA）.Methods Forty-five patients diag-nosed with MCAA were randomly divided into groups A and B.Patients in group A were treated by embolization and those in group B underwent surgical clipping.The clinical efficacy and prognosis were compared between two groups.Results At postoperative 3 d,the GCS score in group A was significantly higher than that in group B,whereas the degree of vasospasm in group A was significantly lower compared with that in group B （both P 〈0.05）.The GCS score and degree of vasospasm did not significantly differ between groups A and B at postoperative 7 and 14 d （both P 〉0.05）.The modified Rankin scale did not significantly differ between two groups at postoperative 30 d （P 〉0.05）.Conclusion Embolization and surgical clipping had similar long-term efficacy in treatment of MCA,whereas embolization can provide higher efficacy during early stage.