介入栓塞术与开颅术治疗脑动脉瘤临床疗效比较

目的 比较介入栓塞术与开颅术治疗脑动脉瘤临床疗效.方法 60例脑动脉瘤破裂的患者采用随机数字表法平均分为两组各30例,A组给予介入栓塞术治疗,B组给予开颅手术治疗.随访观察3个月,记录有无再出血,并采用Glasgow结果评分评价,同时检测治疗前后基质金属蛋白酶-2(MMP-2)水平变化及住院时间.结果 治疗后,A组治疗总有效率73.4％、术后再出血率10.0％ (3/30),B组分别为76.7％、6.7％ (2/30),两组差异均无统计学意义(x2=0.09、0.22,均P＞0.05);两组治疗前MMP-2水平差异无统计学意义(t=1.21,P＞0.05);两组手术治疗后3 d MMP-2水平分别为(20.1±8.7) μg/L、(35.7±8.9) μg/L,两组差异有统计学意义(t =3.33,P＜0.05).A组住院时间(8.6±1.5)d,B组为(13.2±1.3)d,两组差异有统计学意义(t =3.18,P＜0.05).结论 对于脑动脉瘤破裂的患者,采用介入栓塞术治疗与开颅术疗效无明显差异,但可减少住院时间,且明显降低MMP-2水平.

Comparison of the effect of intervention embolization and operation in the treatment of cerebral aneurysms

Objective To compare of intervention embolization and operation in the treatment of brain aneu- rysms. Methods 60 cerebral aneurysm patients using random number table method were divided into two groups each 30 cases, group A given intervention embolization ; group B given surgical operation treatment. They were followed for 3 months, the bleed Glasgow results score, matrix metalloproteinases 2 （ MMP-2 ） level change and the length of time were recorded. Results After treatment, A group total effective rate was 73.4%, postoperative treatment to bleed a- gain rate was 10. 0% （3/30） ,B group was 76.7% ,6. 7% （2/30） ,two groups had no statistically significant differ- ences （χ2 = 0. 09,0.22, all P 〉 0.05 ） before treatment MMP-2 level between ;The two groups was statistically signifi- cant（t = 1.21 ,P〉0.05） ;Two groups after surgical treatment 3 d MMP-2 levels were（20. 1 ±8.7）μg//L, （35.7 ± 8. 9 ） μg//L respectively, which was statistically significant （ t = 3.33, P 〈 0.05 ）. A group of hospitalization time （ 8.6 ± 1.5 ）d, group B （13.2＋ 1.3 ）d, the difference between two groups was statistically significant （t = 3.18, P 〈 0.05 ）. Conclusion For brain aneurysm patients, the intervention embolization had no obvious difference in curative effect with operation, but could reduce the time in hospital and significantly reduced MMP-2 level.