血管内介入治疗大脑中动脉分叉部动脉瘤的临床疗效分析

Clinical Effect of Endovascular Interventional Therapy on Patients with Intra - cerebral Artery Bifurcation Aneurysms

【目的】探讨血管内介入治疗大脑中动脉分叉部动脉瘤患者的临床疗效。【方法】回顾性分析2014年1月至2016年12月本院神经外科收治的72例大脑中动脉分叉部动脉瘤患者的临床资料，根据治疗方法不同分为观察组和对照组，每组各36例。观察组患者采用血管内介入治疗，对照组采用开颅手术夹闭治疗。观察两组患者的临床疗效、并发症，比较两组手术时间、住院时间，术后6个月随访患者的复发及神经功能缺损情况。【结果】术后观察组预后良好的患者所占比例明显高于对照组，预后较差所占比例低于对照组，差异均具有统计学意义（P〈0．05）；但两组病死率比较差异无统计学意义（P〉0．05）。观察组手术时间、住院时间均均小于对照组，差异具有统计学意义（P〈0．06）。观察组手术并发症发生率为11．11％（4／36）明显少于对照组的32．35％（11／36），差异具有统计学意义（P〈0．05）；随访6个月，两组患者的术后复发情况比较，差异无统计学意义（5．56％vs2．78％，x^2=0．411，P=0．522〉0．05）。【结论】血管内介入治疗具有手术时间短，并发症少，术后恢复快，疗效显著且复发率低的优势，是治疗大脑中动脉分叉部动脉瘤安全、可行的方法。

[Objective]To investigate the clinical effect of intravascular interventional therapy on patients with intracerebral artery bifurcation aneurysms .[Methods]From January 2014 to December 2016, 72 patients with aneurysm of middle cerebral artery bifurcation in our hospital were divided into observation group and control group according to the different treatment methods, 36 cases in each group. The patients in the observation group were treated with endovascular treatment. The control group was treated with craniotomy. The clinical efficacy and complications of the two groups were observed. The operative time, hospital stay, and the recurrence and neurological deficit of the two groups were compared after 6 months. [Results]The proportion of patients with good prognosis in the observation group was significantly higher than that in the control group, and the proportion of the poor prognosis in the observation group was lower than that in the control group （ P 〈0.05）, but there was no significant difference in the mortality between the two groups （ P 〉0.05）. The operation time and hospitalization time in the observation group were all smaller than those in the control group, and the difference was statistically significant （ P 〈0.05）. The incidence of postoperative com- plications in the observation group （11.11% （4/36）was significantly lower than that in the control group 32.35% （11/36） （ P 〈0.05）, and there was no significant difference between the two groups in terms of postoperative recurrence after 6 months follow-up（5.56% vs 2.78%,x^2 =0.411, P =0.522〉0.05）. [Conclusion] Endovascular interventional therapy has the advantages of short operation time, less complications, quick postoperative recovery, significant curative effect and low recurrence rate. It is a safe and feasible method for the treatment of middle cerebral artery bifurcation aneurysms.