显微夹闭与血管内介入栓塞治疗对后交通动脉瘤伴动眼神经麻痹患者神经功能恢复的影响比较

Comparison of microsurgical clipping and intravascular interventional embolization on nerve function recovery in patients with posterior communicating aneurysm combined with oculomotor paralyses

目的比较显微夹闭与血管内介入栓塞治疗对后交通动脉瘤伴动眼神经麻痹患者神经功能恢复的影响。方法选择2015年5月至2017年5月于重庆市黔江中心医院收治的86例后交通动脉瘤伴动眼神经麻痹患者,采用随机数字表法将患者分为观察组与对照组,对照组43例应用显微夹闭治疗,观察组43例应用血管内介入栓塞治疗,比较两组患者手术治疗效果、神经功能恢复情况、术后并发症以及预后情况。结果观察组手术时间、术中出血量、术后呼吸恢复时间及术后拔管时间均显著少于对照组(P <0. 05);观察组完全恢复率显著高于对照组,无恢复率显著低于对照组(P <0. 05);观察组总并发症发生率显著低于对照组(P <0. 05);观察组恢复良好率显著高于对照组(P <0. 05)。结论后交通动脉瘤伴动眼神经麻痹患者应用血管内介入栓塞治疗可促使神经功能恢复有效恢复,降低术后并发症发生率,预后效果好,疗效确切,可作为首选治疗方案。

Objective To compare the influences of microsurgical clipping and intravascular interventional embolization on the nerve function recovery in patients with posterior communicating aneurysm combined with ot ulomotor paralyses.Methods Eighty-six patients with posterior communicating artery aneurysm accompanied by oculomotor nerve palsy admitted to Qianjiang Central Hospital of Chongqing from May 2015 to May 2017 were randomly divided into observation group(n=43)and control group(n=43)by random number table method.The control group was treated with microsurgical clipping,while the observation group was treated with intravascular interventional embolization.The therapeutic effect,neurological function recovery,postoperative conijilications and prognosis of the two groups were compared.Results The operation time,intraoperative blood loss,postoperative respiratory recovery time and postoperative extu-bation time of the observation group were significantly less than those of the control group(P<0.05);the complete recovery of the observation group was significantly higher than that of the control group,and no recovery was significantly lower than that of the control group(P<0.05);the incidence of complications in the observation group was significantly lower than that in the control group(P<0.05);the proportion of 5 points in the observation group was significantly higher than that in the control group(P<0.05).Conclusions Intravascular interventional embolization in the treatment of posterior communicating aneurysm combined with oculomotor paralyses can promote the recovery of nerve function,reduce the incidence of postoperative complications,have a good prognosis and a definite effect,which can be used as the first choice of treatment.