血管内栓塞术与血管夹闭术用于颅内动脉瘤破裂急性期的效果比较

Effect comparison of endovascular embolization and vascular clipping for the acute phase of intracranial aneurysm rupture

目的比较血管内栓塞术、血管夹闭术用于颅内动脉瘤破裂急性期的效果。方法选取2016年3月～2018年1月江西省抚州市第一人民医院收治的157例颅内动脉瘤破裂急性期患者作为研究对象,按照随机数字表法将其分为观察1组(81例,行血管夹闭术)和观察2组(76例,行血管内栓塞术)。比较两组患者的手术指标(术中出血量、医疗费用、住院用时)及术后并发症发生情况,所有患者均门诊随访6个月,观察两组的预后情况。结果观察2组患者的术中出血量少于观察1组,医疗费用高于观察1组,住院用时短于观察1组,差异有统计学意义(P<0.05)。两组患者的预后良好率比较,差异无统计学意义(P>0.05)。观察2组患者的术后感染率低于观察1组,血管痉挛发生率高于观察1组,差异有统计学意义(P<0.05);两组患者的术后脑缺血、动脉瘤破裂及并发症总发生率比较,差异无统计学意义(P>0.05)。结论血管内栓塞术、血管夹闭术用于颅内动脉瘤破裂急性期治疗,患者的预后效果均良好,前者术中出血量少、术后恢复快、感染率低,后者医疗费用低、血管痉挛少。

Objective To compare the effect of endovascular embolization and vascular clipping for the acute phase of intracranial aneurysm rupture. Methods A total of 157 patients with acute intracranial aneurysm rupture from March 2016 to January 2018 admitted to the First People′s Hospital of Fuzhou in Jiangxi Province were enrolled in the study. They were divided into the observation group 1 (n=81, treated with vascular clamping) and the observation group 2 (n=76, treated with endovascular embolization) according to the random number table method. The surgical indexes (intraoperative blood loss, medical expenses, hospitalization time) and postoperative complications were compared between the two groups. All patients were followed up for 6 months in the outpatient department to observe the prognosis of the two groups. Results The intraoperative blood loss of the observation group 2 was less than that of the observation group 1, the medical expenses were higher than that of the observation group 1, the hospitalization time was shorter than that of the observation group 1, and the differences were statistically significant (P<0.05). There was no significant difference in the good prognosis rate between the two groups (P>0.05). The postoperative infection rate of the observation group 2 was lower than that of the observation group 1, the incidence rate of vasospasm was higher than that of the observation group 1, and the differences were statistically significant (P<0.05). There were no significant differences in the incidence rates of postoperative cerebral ischemia, aneurysm rupture and total complications between the two groups (P>0.05). Conclusion Both endovascular embolization and vascular clipping used for the treatment of acute intracranial aneurysm rupture can obtain the good prognosis. The former has less intraoperative blood loss, faster postoperative recovery and lower infection rate, while the latter has lower medical expenses and less vasospasm.