大脑中动脉瘤应用血管内介入栓塞术与锁孔夹闭术的疗效对比

Comparison of Endovascular Catheterization and Keyhole Clamping in the Treatment of Middle Cerebral Aneurysm

目的采取血管内介入栓塞术及锁孔开颅夹闭术对大脑中动脉瘤治疗的临床疗效对比。方法回顾锦州医科大学附属第一医院神经外科2017年9月至2019年3月收治的大脑中动脉瘤患者88例,分为锁孔开颅夹闭术组(A组44例)以及血管内介入栓塞术组(B组44例),并对比两者手术时间、术中出血、住院时间、平均费用、临床疗效、术后并发症以及复发情况。结果A组患者的住院时间、术中出血量以及手术时间均要多于B组,且差异具有统计学意义(P<0.05),但是B组的手术的花费则是要高于A组患者,且差异具有统计学意义(P<0.05)。患者的术后发生脑积水、脑血管痉挛、术后感染并发症的发生率而言,两组患者之差异无统计学意义,B组为13.64%(6/44),而A组为18.18%(8/44),但是B组复发率则高于A组,且两组差异具有统计学意义(P<0.05)。治疗效果方面B组为90.90%(40/44),A组为86.36%(38/44),差异无统计学意义。结论血管内介入栓塞术治疗具有周围组织损伤小、住院时间短等优点,然而,临床上需要结合患者实际情况及家庭经济状况有针对性的选择手术方式。

Objective To compare the clinical efficacy of intravascular interventional embolization and keyhole craniotomy in the treatment of middle cerebral artery aneurysm.Methods 88 patients with middle cerebral artery aneurysm admitted to the Department of Neurosurgery in the First Affiliated Hospital of Jinzhou Medical University from September 2017 to March 2019,were divided into the keyhole craniotomy group(group A,44 cases)and the endovascular interventional embolization group(Group B,44 cases).The operation time,intraoperative bleeding,hospitalization time,average cost,clinical efficacy,postoperative complications and recurrence were compared.Results The hospitalization time,intraoperative blood loss and operation time of patients in group A were more than those of group B,with group A and the difference was statistically significant(P<0.05).There was no statistically significant difference between the two groups in terms of incidence of postoperative hydrocephalus,cerebral vasospasm,and postoperative infective complications.The incidence of Group B was 13.64%(6/44),while that of Group A was 18.18%(8/44).The recurrence rate of group B was higher than that of group A,with statistically significant difference(P<0.05).The therapeutic effect was 90.90%(40/44)in group B and 86.36%(38/44)in group A,with no statistically significant difference.Conclusion Endovascular interventional embolization has the advantages of less damage to the surrounding tissue and short hospitalization time.However,it is necessary to select the surgical method based on the actual situation of the patients and the economic situation of the family.