血管内介入术与开颅夹闭术治疗脑动脉瘤的疗效分析

Therapeutic effect of endovascular intervention and craniotomy in the treatment of cerebral aneurysms

目的研究血管内介入术与开颅夹闭术治疗脑动脉瘤的临床疗效。方法选择重庆市涪陵中心医院2012年1月至2018年12月期间实施开颅夹闭术的200例脑动脉瘤患者为A组与实施血管内介入术的350例脑动脉瘤患者为B组。比较两组的手术用时、术后住院时间、术后并发症发生率、术后疼痛评分、预后分级和生存质量评分。结果 B组手术用时和术后住院时间均短于A组;B组术后并发症总发生率为1.14%低于A组7.00%,差异有统计学意义;术后第1和第3天,B组VAS评份均低于A组;术后6个月,两组均无死亡病例,B组整体预后优于A组;术后6个月,B组的生存质量评分各维度得分均高于A组,差异有统计学意义(P<0.05)。结论血管内介入术较开颅夹闭术,可有效减轻脑动脉瘤患者的手术创伤、术后疼痛感,减少术后并发症,有利于缩短术后住院时间,改善预后,提高生存质量。

Objective To study the clinical effect of endovascular intervention and craniotomy clipping in the treatment of cerebral aneurysms.Method 200 patients with cerebral aneurysms who underwent craniotomy and clipping from January 2012 to December 2018 in Fuling Central Hospital of Chongqing City were selected as group A and 350 patients with cerebral aneurysms who underwent endovascular interventions as group B.The operation time,hospitalization time,incidence of complications,pain score,prognosis grade and quality of life score were compared between the two groups.Result The total incidence of complications in group B was 1.14%lower than 7.00%in group A.The VAS scores in group B were lower than those in group A on the first and third days after operation.There were no deaths in both groups at 6 months after operation,and the overall prognosis in group B was better than that in group A.At 6 months after operation,the quality of life in group B was better than that in group A.The scores of each dimension were higher than those of group A,and the difference was statistically significant(P<0.05).Conclusion Compared with craniotomy and clipping,endovascular intervention can effectively relieve the trauma and pain of patients with cerebral aneurysms,reduce the complications,shorten the hospital stay,improve the prognosis and improve the quality of life.