颅内动脉瘤破裂早期显微手术与血管内栓塞治疗的临床疗效观察

目的观察分析显微手术和血管内栓塞介入治疗对颅内动脉瘤破裂早期的的临床疗效。方法对105例共113个颅内动脉瘤破裂早期的患者分别采用显微手术和血管内栓塞治疗的方法进行治疗。其中53例59个颅内动脉瘤患者采用显微技术治疗,52例54个颅内动脉瘤患者采用采用血管内栓塞治疗。利用格拉斯哥结果量表（GOS）评价治疗效果,并总结颅内动脉瘤破裂早期治疗的教训和经验。结果显微手术治疗患者中有79.2%患者手术后预后良好,9.4%患者中残,5.7%患者重残,1.9%患者植物生存,3.7%患者死亡;血管内栓塞介入治疗患者中有76.9%患者预后良好,7.7%患者中残,3.8%患者重残,1.9%患者植物生存,9.6%患者死亡。结论颅内动脉瘤破裂早期采用显微手术和血管内栓塞治疗都能取得较满意的效果,治疗效果的差异无统计学意义（P〉0.05）。显微手术与血管内栓塞治疗颅内动脉瘤各有利弊,且相互补充,临床治疗时应依据动脉瘤的部位、大小、主治医师的技能和患者的意愿进行综合的考虑,以确定一个最优的治疗方案。

Observation on the Clinical Curative Effect of Microsurgery and Endovascular Embolization in the Treatment of Early Rupture of Intracranial Aneurysm

Objective To observe and analyze the clinical effect of microsurgery and endovascular interventional therapy in the treatment of early rupture of intracranial aneurysm. Methods 105 cases of patients with a total of 113 early rupture of intracranial aneurysms were given microsurgery and endovascular embolization for treatment, respectively. 53 patients with 59 intracranial aneurysm were treated by microsurgery, and 52 cases with 54 intracranial aneurysm were treated with endovascular embolization.All patients were evaluated by Glascow Outcome Scales（GOS）. And the lessons and experience of early rupture of intracranial aneurysm were summarized. Results Among the 53 cases of patients treated by microsurgery, 79.2% of the patients had good recovery, 9.4% of the patients were moderate disability, 5.7% of the patients were severe disability, while 1.9% of the patients were in vegetative status and 3.7% of the patients were dead. Among those 52 cases treated with endovascular embolization, 76.9% of the patients had good recovery, and 7.7% of the patients were moderate disability, 3.8% of the patients were severe disability, while1.9% of the patients were in vegetative status, and 9.6% of the patients were dead. Conclusion Both microsurgery and endovascular embolization for intracranial aneurysm can obtain satisfactory effect, the difference in treatment effect between the two is not statistically significant（P〉 0.05）. With there own merits and demerits, the two methods should be approached complementarily.Whether to choose the microsurgery or the endovascular embolization relies on not only the size and position of the aneurysm, but also the experience of the surgeon and the will of the patients.