开颅夹闭术与血管介入栓塞术治疗老年脑动脉瘤的疗效比较

Comparison of the efficacy of craniotomy clipping and vascular interventi onal embolization in the treatment of cerebral aneurysms in the elderly

目的:研究用开颅夹闭术与血管介入栓塞术对老年脑动脉瘤患者进行治疗的临床效果。方法:选择2016年7月至2020年12月期间麻城市人民医院收治的老年脑动脉瘤患者100例作为研究对象。按照随机数表法将其分为血管介入栓塞组和开颅夹闭组(50例/组)。为开颅夹闭组患者采用开颅夹闭术进行治疗,为血管介入栓塞组患者采用血管介入栓塞术进行治疗,然后比较两组患者治疗的总有效率、手术指标(手术时间、住院费用、住院时间)、术后并发症(再出血、脑积水、脑血管痉挛、肺部感染)的发生率和Glasgow昏迷评分。结果:血管介入栓塞组患者治疗的总有效率高于开颅夹闭组患者,差异有统计学意义(P<0.05);血管介入栓塞组患者的手术时间、住院时间均短于开颅夹闭组患者,其住院费用高于开颅夹闭组患者,差异有统计学意义(P<0.05);血管介入栓塞组患者术后并发症的发生率低于开颅夹闭组患者,差异有统计学意义(P<0.05);两组患者的Glasgow昏迷评分相比,差异无统计学意义(P>0.05)。结论:老年脑动脉瘤患者通过血管介入栓塞术进行治疗,其治疗的总有效率、术后并发症的发生率均优于开颅夹闭术,且手术时间更短,住院时间更短,但住院费用高于开颅夹闭术,整体来说,应用价值较高。

Objective:To study the clinical effect of craniotomy clipping and vascular interventional embolization in the treatment of elderly patients with cerebral aneurysm.Methods:A total of 100 elderly patients with cerebral aneurysm admitted to Macheng People’s Hospital from July 2016 to December 2020 were selected as the research objects.According to the random number table method,they were divided into vascular interventional embolization group and craniotomy clipping group(50 cases/group).Patients in the craniotomy clipping group were treated with craniotomy clipping,and patients in the vascular interventional embolization group were treated with vascular interventional embolization.Then the total effective rate,surgical indicators(operation time,hospitalization cost,length of stay),postoperative complications(rebleeding,hydrocephalus,cerebral vasospasm,pulmonary infection)and Glasgow coma score were compared between the two groups.Results:The total effective rate of vascular interventional embolization group was higher than that of craniotomy clipping group,and the difference was statistically significant(P<0.05).The operation time and hospital stay of patients in vascular interventional embolization group were shorter than those in craniotomy clipping group,and the hospitalization cost was higher than that in craniotomy clipping group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in vascular interventional embolization group was lower than that in craniotomy clipping group,and the difference was statistically significant(P<0.05).There was no significant difference in Glasgow coma score between the two groups(P>0.05).Conclusion:In elderly patients with cerebral aneurysm treated by vascular interventional embolization,the total effective rate and incidence of postoperative complications are better than craniotom y clipping,and the operation tim e is shorter,the length of hos pital stay is shorter,but the hospitalization cost is higher than craniot omy clipping,overall,the application value is higher.