颅内动脉瘤施行早期动脉瘤夹闭术的效果观察

目的 探讨颅内动脉瘤施行早期动脉瘤夹闭术的临床效果.方法 选择颅内动脉瘤患者72例,42例(44个动脉瘤)行显微手术夹闭(夹闭组),30例(33个动脉瘤)行血管栓塞术(栓塞组).观察两组患者预后评价和临床指标.结果 两组GOS评价和mRS评价差异均无统计学意义(均P＞0.05).夹闭组住院时间、住院费用、完全闭塞率分别为(17.1±3.2)d、(5.5±1.2)万元、100.0％,均优于栓塞组的(9.1±2.6)d、(12.1±2.6)万元、83.3％(均P＜0.05)；两组脑血管瘤破裂率和并发症发生率差异均无统计学意义(x2=0.01、0.02,均P＞0.05).结论 显微手术夹闭和血管栓塞预后疗效相当,各有优缺点,显微手术夹闭可以作为首选治疗方法,尤其适宜在基层医院推广应用.

Effect observation of early aneurysm surgery clipping in the treatment of intracranial aneurysm

Objective To investigate the clinical effects of early aneurysm surgery clipping in the treatment of intracranial aneurysm. Methods 72 patients with intracranial aneurysms were selected. 42 patients （44 aneu- rysms） were taken microsurgical clipping（ clipping group） ,30 patients（ 33 anenrysms） were taken vascular emboliza- tion（ embolization group）. The prognostic evaluation and clinical indicators of two groups were observed. Results There were no significant differences in GOS evaluation when discharge and mRS evaluation after postoperative 3 months in two groups（ all P 〉 0.05 ）. The length of stay, hospital cost and complete occlusion rate of clipping group was（ 17. 1 ± 3.2 ） d, （5.5 ± 1.2） ten thousand yuan, 100.0%, respectively, and better than those of embolization group （ 9.1 ±2.6） d, （ 12.1 ± 2.6） ten thousand yuan, 83.3 % ] （ all P 〈 0.05 ）. There were no significant differences in cerebral aneurysms rupture rate and complication rate between the two group （ X2 = 0.01,0.02, all P 〉 0.05 ）. Conclusion The microsurgical clipping has the therapeutic equivalence with embolization group, and has respective advantages and disadvantages. The microsurgical clipping could be the preferred treatment method, especially suitable for application in the primary hospital.