神经外科夹闭及血管内栓塞治疗老年颅内动脉瘤效果比较.docVIP

神经外科夹闭及血管内栓塞治疗老年颅内动脉瘤效果比较 　　[摘要] 目的 比较神经外科开颅夹闭和血管内栓塞治疗老年颅内动脉瘤患者的有效性和安全性，为此类患者选择科学的治疗方案提供指导。方法 方便选取该院2009年3月―2012年12月神经外科收治的62例老年颅内动脉瘤患者作为观察对象，其中行外科开颅夹闭者28例，动脉瘤合计31个；其余34例患者进行血管内弹簧圈栓塞治疗，动脉瘤合计36个。观察患者患者栓塞率及并发症发生率。结果 血管内栓塞组动脉瘤完全栓塞组21例，占61.76%，栓塞率小于70%的患者3例，占8.82%，瘤颈处有半月形残留者11例，占32.35%；出院时GOS评分结果显示开颅夹闭术组和血管内弹簧栓塞组评分差异无统计学意义（χ2=0.379，P0.05）。结论 开颅夹闭术和血管内栓塞术治疗老年颅内动脉瘤患者的效果相差无几，但血管内栓塞由于创伤小，尤为适宜老年患者的治疗 [关键词] 颅内动脉瘤； 老年人； 血管内栓塞；开颅夹闭 [中图分类号] R651.1 [文献标识码] A [文章编号] 1674-0742（2016）11（a）-0100-03 [Abstract] Objective To compare the efficacy and complications of treatment of microsurgical clipping with that of endovascular embolization in the elder patients with intracranial aneurysms. Methods Convenient selection 62 Cases selected from March 2009 to December 2012 were elderly patients with intracranial aneurysms in neurosurgery department. 28 cases were underwent microsurgical clipping， aneurysm were 31 totally. 34 cases were underwent endovascular coil embolization treatment and aneurysm totally 36. The rate of embolism and the incidence of complications were observed. Results The endovascular embolization group 21 cases had successfully embolization with the rate of 61.76%， 3 cases embolization rate less then 70% and 32.35% cases had half-moom residual aneurysm about 11 cases. Two group patients showed GOS score at discharged stage were statistically no significant（χ2=0.379，P0.05）. Conclusion Microsurgical clipping and endovascular embolization has similar significance， but the latter most suit for elder patients with intracranial aneurysms. [Key words] Intracranial aneurysms； Elderly； Endovascular embolization； Craniotomy clipping ?B内动脉瘤是引发脑血管疾病的第三位病因，是导致蛛网膜下腔出血的首要致病因素，有研究认为，颅内动脉瘤的发病率为3.6%～6%，其中1%～2%患者发生动脉瘤破裂，因该病死亡的患者占脑血管疾病患者的22%～25%，如果不及时治疗，其2年内死亡率达75%以上，约半数以上的存活者会伴有严重残疾，严重影响患者生活质量，给社会和家庭带来沉重的经济负担[1-4]。该文以2009年3月―2012年12月的62例老年颅内动脉瘤患者作为观察对象，比较两种治疗方式在此类患者中的治疗效果及安全性，现报道如下 1 资料与方法 1.1 一般资料 方便选取该院神经外科收治的62例老年颅内动脉瘤患者作为观察对象，患者均通过血管造影术明确诊断，均以蛛网膜下腔出血起病。根据治疗方式的不同，将患