动脉瘤颈夹闭术与血管内栓塞术治疗颅内动脉瘤破裂急性期患者临床效果的对比研究

Comparative Study for Clinical Effect on Acute Rupture of Intracranial Aneurysms between Aneurysmal Neck Clipping and Endovascular Embolization

目的比较动脉瘤颈夹闭术与血管内栓塞术治疗颅内动脉瘤破裂急性期患者的临床效果。方法选取2015年1月—2017年10月内蒙古林业总医院收治的颅内动脉瘤破裂急性期患者90例,采用随机数字表法分为对照组和观察组,每组45例。对照组患者行动脉瘤颈夹闭术,观察组患者行血管内栓塞术。比较两组患者手术时间、术中出血量、住院时间、术后并发症发生率、术后2个月SF-36量表评分及预后。结果观察组患者手术时间、住院时间短于对照组,术中出血量少于对照组,术后并发症发生率低于对照组(P<0.05)。术后2个月观察组患者躯体功能、情绪功能、角色功能、社会功能、总体健康评分高于对照组(P<0.05)。术后2个月两组患者预后比较,差异无统计学意义(P>0.05)。结论动脉瘤颈夹闭术、血管内栓塞术均可有效改善颅内动脉瘤破裂急性期患者预后,但与动脉瘤颈夹闭术相比,血管内栓塞术可更有效地缩短手术时间及住院时间,减少术中出血及术后并发症的发生,改善患者生存质量。

Objective To compare the clinical effect on acute rupture of intracranial aneurysms between aneurysmal neck clipping and endovascular embolization. Methods A total of 90 patients with acute rupture of intracranial aneurysms were selected in Inner Mongolia General Hospital for Forestry from January 2015 to October 2017,and they were divided into control group and observation group according to random number table,each of 45 cases. Patients in control group received aneurysmal neck clipping,while patients in observation group received endovascular embolization. Duration of operation,intraoperative blood loss,hospital stays,incidence of postoperative complications,SF-36 scale score and prognosis 2 months after operation were compared between the two groups. Results Duration of operation and hospital stays in observation group were statistically significantly shorter than those in control group,intraoperative blood loss in observation group was statistically significantly less than that in control group,meanwhile incidence of postoperative complications in observation group was statistically significantly lower than that in control group（P〈0.05）. Physical function score,emotional function score,role function score,social function score and overall health score in observation group were statistically significantly higher than those in control group 2 months after operation（P〈0.05）. No statistically significant differences of prognosis was found between the two groups 2 months after operation（P〈0.05）. Conclusion Both aneurysmal neck clipping and endovascular embolization can effectively improve the prognosis in patients with acute rupture of intracranial aneurysms,but compared with aneurysmal neck clipping,endovascular embolization can more effectively shorten the duration of operation and hospital stays,reduce the intraoperative blood loss and risk of postoperative complications,improve the quality of life.