显微外科夹闭和血管内介入栓塞治疗动脉瘤性蛛网膜下腔出血临床疗效分析

Analysis of clinical efficacy of microsurgical clipping and endovascular embolization in the treatment of aneurysmal subarachnoid hemorrhage

目的分析显微外科夹闭和血管内介入栓塞治疗动脉瘤性蛛网膜下腔出血(ASAH)的临床疗效。方法选择ASAH患者138例,根据治疗方式不同分为栓塞组(n=71)和夹闭组(n=67)。比较两组一般资料、手术情况、住院期并发症,以及出院时、出院后3个月临床神经功能(预后)。结果栓塞组手术时间、术中出血量、住院时间少于夹闭组(P<0.05)。出院时栓塞组预后不良发生率低于夹闭组(P<0.05);而出院后3个月,两组预后不良发生率差异无显著性(P>0.05)。夹闭组肺部感染、颅内感染及并发症总发生率高于栓塞组(P<0.05)。结论显微外科夹闭和介入栓塞治疗ASAH均有良好的短期疗效,但介入栓塞手术时间、住院时间更短,出血量和并发症更少。

Aim To investigate the clinical efficacy of microsurgical clipping and endovascular embolization in the treatment of aneurysmal subarachnoid hemorrhage(ASAH).Methods The clinical data of 138 ASAH patients were retrospectively analyzed.Patients were divided into the embolization group(n=71)and the clipping group(n=67)according to different treatment methods.General and surgical information of patients,as well as complications since hospitalization,were collected,and their clinical neurological function at discharge and three months after discharge were evaluated.Results The surgical time,intraoperative bleeding,and hospital stay in the embolization group were shorter than those in the clamp group(P<0.05).The incidence of poor prognosis in the embolization group was lower than that in the clamp group at discharge(P<0.05).After 3 months of discharge,there was no significant difference in the incidence of poor prognosis between the two groups(P>0.05).The total incidence of pulmonary infection,intracranial infection,and complications in the clamp group was higher than that in the embolization group(P<0.05).Conclusion Microsurgical clipping and interventional embolization have good short-term efficacy in treating ASAH,but interventional embolization has shorter surgical time and hospital stay,less bleeding and fewer complications.