不同方法治疗破裂脑动脉瘤的疗效分析

Analysis of the effect of different methods on the treatment of ruptured cerebral aneurysms

目的:分析不同方法治疗破裂脑动脉瘤的效果。方法:选取2017年1月至2020年1月收治的100例脑动脉瘤患者为研究对象,按治疗方法分为血管栓塞术组和显微手术夹闭组,各50例;血管栓塞组是采用介入的方法用弹簧圈将动脉瘤栓闭,显微夹闭组是采用翼点入路开颅将动脉瘤夹闭。对比两组患者临床手术效果、治疗有效率以及并发症发生率。结果:显微手术夹闭组手术时间为(180.55±9.17)min,血管栓塞组手术时间(76.48±7.35)min,显微手术夹闭组手术时间明显高于血管栓塞组。治疗后显微手术夹闭组手术时间、术中出血量、VAS评分以及术后恢复时间均与血管栓塞术组存在差异(P<0.05);显微手术夹闭组并发症发生率低于血管栓塞术组(χ^(2)=4.162,P=0.041);治疗有效率方面,两组患者差异无统计学意义(χ^(2)=0.126,P=0.722)。结论:显微手术夹闭与血管栓塞术对破裂脑动脉瘤的治疗效果差异不大,血管栓塞术手术时间少于显微手术夹闭,但显微手术夹闭在并发症预防方面表现更佳,医生可根据患者病情特征选择最佳手术方式。

Objective:To analyze the effects of different methods in the treatment of ruptured cerebral aneurysms.Methods:100 cases of cerebral aneurysm admitted from January 2017 to January 2020 were selected as the research objects.According to the treatment method,they were divided into vascular embolization group and microsurgery clipping group,50 cases in each.In the vascular embolization group,the aneurysm was clipped with spring coil by interventional method,while in the microclipping group,the aneurysm was clipped by pterional approach craniotomy.The clinical operation effect,treatment efficiency and complication rate were compared between the two groups.The clinical operation effect,effective rate of treatment and the incidence of complications were compared between the two groups of patients.Results:The operation time of the microsurgical clipping group was 180.55±9.17 min,and that of the vascular embolization group was 76.48±7.35 min.The operation time of the microsurgical clipping group was significantly higher than that of the vascular embolization group.There were differences in operation time,intraoperative blood loss,VAS score and postoperative recovery time between the microsurgical clipping group and the vascular embolization group after treatment(P<0.05).The complication rate of microsurgical clipped group was lower than that of vascular embolization group(χ^(2)=4.162,P=0.041).There was no significant difference in the effective rate between the two groups(χ^(2)=0.126,P=0.722).Conclusion:There is no significant difference between microsurgical clipping and vascular embolization in the treatment of ruptured cerebral aneurysms.The operative time of vascular embolization is less than that of microsurgical clipping,but the performance of microsurgical clipping in the prevention of complications is better.Patients can choose the best surgical method according to their condition characteristics.