开颅夹闭术和血管内栓塞术治疗老年前交通动脉破裂动脉瘤的疗效对比分 析

目的 比较开颅夹闭术和血管内栓塞术治疗老年前交通动脉破裂动脉瘤的疗效。方法 2011年6月至2014年10月收治老年（年龄≥60岁）前交通动脉破裂动脉瘤53例，采用开颅夹闭术31例（夹闭组），血管内栓塞术22例（栓塞组）。结果 夹闭组术后并发症发生率（48.4%）明显高于栓塞组（18.2%；P<0.05）。出院后3个月，按gos评分评估预后。夹闭组预后良好18例（gos评分≥4分），重残7例，植物生存4例，死亡2例；栓塞组预后良好19例，重残2例，植物生存1例；夹闭组预后良好率（58.1%）明显低于栓塞组（86.3%；>P<0.05）。>结论 对于老年前交通动脉破裂动脉瘤，可采取夹闭术和栓塞术两种方式，但是栓塞术可在明确诊断的同时进行治疗，创伤较小，能有效降低再出血率和并发症发生率，安全性较高，特别适合不能耐受开颅夹闭术的老年患者。

Craniotomy clipping and interventional treatment of ruptured anterior communicating artery aneurysms in elderly patients: comparison of curative effects

Objective To compare the curative effect of microsurgery on ruptured anterior communicating artery (ACoA) aneurysms with that of interventional treatment in elderly patients. Methods Of 53 elderly patients (age≥60 years) with ruptured ACoA aneurysms, 31 were treated by microsurgery and 22 by interventional treatment. The Complication occurrence rates and prognoses were compared between both the groups. Results The complication occurrence rate (48.4%, 15/31) was significantly higher in microsurgery group than that (18.2%, 4/22) in the interventional group (PP<0.05).>Conclusion The curative effect of interventional treatment on the ruptured ACoA aneurysms is significantly better than that of surgical clipping in elderly patients.