开颅夹闭手术与血管栓塞介入术治疗脑动脉瘤破裂的临床效果探讨

Interventional Treatment of Craniotomy and Vascular Embolization for the Treatment of Cerebral Aneurysm Rupture

目的探讨在脑动脉瘤破裂中采用开颅夹闭术和血管栓塞介入术治疗的临床疗效。方法随机选取2015年7月—2017年7月该院收治的94例脑动脉瘤破裂患者为研究对象,按照不同的手术方式将所有患者随机分为参照组与研究组,每组各47例。其中参照组采用开颅夹闭术,研究组采用血管栓塞介入术。对两组患者住院费用,手术时间,住院天数及术后并发症等相关指标加以比较。结果研究组患者在手术时间与住院时间上明显比参照组短,住院费用增加(P<0.05)。两组患者在尿路感染,肺部感染,脑积水,肺血管痉挛,严重电解质紊乱发生率等情况上比较差异无统计学意义(P>0.05)。研究组患者的恢复良好率和轻度残疾率(25.53%),植物生存率(4.26%),中度残疾率(6.38%)和死亡率(2.13%)较参照组相比降低(χ~2=11.647,P<0.05)。结论在脑动脉瘤破裂的临床治疗中采用血管介入栓塞术治疗的临床效果更加显著,从远期来看疗效突出,值得临床上进一步推广和应用。

Objective To investigate the clinical efficacy of craniotomy and vascular embolization in the treatment of cerebral aneurysm rupture. Methods A total of 94 patients with cerebral aneurysm rupture admitted to the hospital from July 2015 to July 2017 were randomly selected. All patients were randomly divided into reference group and study group according to different surgical methods, with 47 cases in each group. The reference group was treated with craniotomy and the study group was treated with vascular embolization. The hospitalization expenses, operation time, hospitalization days and postoperative complications of the two groups were compared. Results The patients in the study group were significantly shorter than the reference group in the operation time and hospitalization time, and the hospitalization expenses increased （P〈0.05）. There were no significant differences in the incidence of urinary tract infection, pulmonary infection, hydrocephalus, pulmonary vasospasm, and severe electrolyte disturbance between the two groups （P〉0.05）. Patients in the study group had a good recovery rate and mild disability rate（25.53%）, plant survival rate（4.26%）, moderate disability rate （6.38%）, and mortality rate（2.13%） decreased compared with the reference group（χ2=1 1.647, P〈0.05）. Conclusion The clinical effect of vascular interventional embolization in the clinical treatment of cerebral aneurysm rupture is more significant, and the curative effect is outstanding in the long term. It is worthy of further promotion and application in clinical practice.