手术夹闭和血管内介入栓塞治疗低分级大脑中动脉分叉部动脉瘤的临床疗效

Efficacy of surgical clipping and endovascular interventional embolization in treatment of low-grade middle cerebral artery bifurcation aneurysms

目的探讨显微外科手术夹闭与血管内介入栓塞术治疗Hunt-Hess低分级大脑中动脉分叉部动脉瘤的临床疗效。方法回顾性分析我院收治的54例Hunt-Hess低分级大脑中动脉分叉部动脉瘤患者的临床资料,根据治疗方法的不同将其分为手术组(33例)和介入组(21例),手术组采用显微外科手术夹闭治疗,介入组采用血管内介入栓塞术治疗。比较2组患者的住院时间、治疗费用、治疗效果、并发症发生率、瘤颈残余率和复发率。结果2组患者住院时间、并发症发生率、术后6个月mRS评分及复发率比较,差异均无统计学意义(P>0.05);介入组患者治疗费用及术后1年瘤颈残余率均高于手术组,差异均有统计学意义(P<0.05)。结论显微外科手术夹闭和血管内介入栓塞术治疗Hunt-Hess低分级大脑中动脉分叉部动脉瘤均安全、有效,但血管内介入栓塞术的瘤颈残余率相对较高,且患者需要承担高昂的治疗费用,目前治疗Hunt-Hess低分级大脑中动脉分叉部动脉瘤仍倾向于采用显微外科夹闭术。

Objective To explore the clinical efficacy of microsurgical clipping and endovascular interventional embolization in the treatment of Hunt-Hess low-grade middle cerebral artery bifurcation aneurysms.Methods The clinical data of 54 patients with Hunt-Hess plications,residual rate of aneurysm neck and recurrence rate of aneurysm were compared between the two groups.Results There was no significant difference in hospitalization time,incidence of complications,mRS score and recurrence rate 6 months after operation between the two groups(P>0.05).The treatment cost and the residual rate of aneurysm neck 1 year after operation in the intervention group were significantly higher than those in the operation group(P<0.05).Conclusion Both microsurgical clipping and endovascular embolization are safe and effective in the treatment of Hunt-Hess low-grade middle cerebral artery bifurcation aneurysms.However,endovascular embolization has a relatively high residual rate of tumor neck,and patients need to bear high treatment costs.At present,microsurgical clipping is still preferred in the treatment of Hunt-Hess low-grade middle cerebral artery bifurcation aneurysms.