手术夹闭动脉瘤颈治疗颅内动脉瘤破裂的疗效及安全性

Efficacy and safety of surgical clipping of aneurysm neck in treating ruptured intracranial aneurysm

目的观察手术夹闭动脉瘤颈治疗颅内动脉瘤破裂的临床效果和并发症。方法选取82例颅内动脉瘤破裂患者为研究对象,按照住院号单双分成2组,对照组41例予介入治疗,观察组41例予手术夹闭动脉瘤颈治疗,观察治疗后临床效果和并发症情况。结果对照组mRS评分、即刻动脉瘤完全闭塞率、不完全闭塞、复发率均明显高于观察组(P<0.05);2组治疗后较治疗前PF、RP、RE均有提高(P均<0.05),观察组治疗后较对照组PF、RP、RE改善幅度明显占优(P<0.05);2组治疗后GOS评分比较差异无统计学意义(P>0.05);对照组脑水肿、脑梗死、颅内出血、脑积水发生率均高于观察组(P<0.05),而脑神经损伤比较差异无统计学意义(P>0.05)。结论手术夹闭动脉瘤颈治疗颅内动脉瘤破裂临床效果满意。

Objective To observe clinical efficacy and adverse events of the surgical clipping of the aneurysm neck in the treatment of ruptured intracranial aneurysms. Methods According to odd-or-even of admission number,82 cases with ruptured intracranial aneurysm were divided into two groups. 41 cases in the control group received interventional therapy and others in the intervention group received surgical clipping of the aneurysm neck. The clinical effects and complications of the two groups were compared. Results The control group showed higher mRS scores,instantly total occlusion rate,incomplete occlusion rate and relapse rate than the observation group （P〈0.05）;Before treatment, the levels of PF, RP and RE were increased （P〈0.05）, which were obviously decreased in the observation group compared with those in the control group after treatment （P〈0.05）. No significant difference was found in GOS scores after treatment （P〉0. 05） ;The incidence rates of cerebral edema, cerebral infarction,intracranial hemorrhage, hydrocephalus in the control group were higher than those in the observation group （P〈0.05） ,but cranial nerve injury showed no significant difference （P〉0.05）. Conclusion Surgical clipping of aneurysm neck has a satisfactory effect on treating ruptured intracranial aneurysms.