颅内动脉瘤显微手术及血管内栓塞治疗的比较研究

目的比较显微外科手术和血管内栓塞治疗颅内动脉瘤疗效和相关并发症。方法对62例64个颅内动脉瘤外科治疗,其中行显微手术瘤颈夹闭34例,血管内电解可脱性弹簧圈栓塞治疗28例;对两组疗效和并发症进行比较分析。结果显微手术组:33例成功夹闭瘤颈(其中2例分离瘤颈时动脉瘤破裂),1例合并脑内血肿在清除血肿后急性脑膨出未能显露动脉瘤;手术相关并发症4例,死亡2例。31例术后两周复查血管造影,动脉瘤完全夹闭83.9%(26/31)。血管内栓塞组:动脉瘤完全闭塞70.0%(21/30);血管内栓塞相关并发症2例,无死亡。结论显微手术和血管内栓塞是治疗颅内动脉瘤的有效方法,二者互有优缺点,相互补充。

Comparison of microsurgical clipping and endovascular interventional therapy for intracranial aneurysms

Objective To compare efficacy and complication of microsurgery and endovascular interventional therapy for intracranial aneurysms.Methods Microsurgical clipping(34 cases) or interventional embolization(28 cases with 30 aneurysms) was performed in 62 patients with 64 intracranial aneurysms.Results In microsurgical clipping group,the neck of the aneurysms was successfully clipped in 33 patients,thereinto aneurysms ruptured in 2 patients during the procedure of dividing the neck of the aneurysms,1 patient with intracerebral hematoma clipping failed because of acute cenencephalocele after cleaning hematoma.4 cases suffered from complications related to the operation,2 cases died.DSA follow-up revealled that 83.9%(26/31) of aneurysms were completely clipped in 2 weeks after microsurgery.In interventional embolization group,83.9%(26/31) of aneurysms were completely clipped,2 cases suffered from complications related to the embolization,no cases died.Conclusion Both microsurgery and endovascular interventional therapy are effective methods for the treatment of intracranial aneurysms.