血管内治疗与外科夹闭颅内破裂动脉瘤性的预后分析.docVIP

精品论文 参考文献 血管内治疗与外科夹闭颅内破裂动脉瘤性的预后分析 张皓春 刘春平 蒲国民 刘素君 王艳 黄桂香 　　（四川省达州市中心医院神经内科 635000） 　　【摘要】目的：对比外科手术与血管内弹簧圈栓塞治疗颅内动脉瘤性SAH患者的预后。方法：收集2009年1月～2012年7月本院神内外科收治的继发于颅内动脉瘤破裂的SAH患者临床资料56例，其中女性34例，男性22例。评价预后标准包括：格拉斯哥预后扩展评分（GOSE）以及12个月内再出血情况。结果：行手术治疗患者占57.1%，介入治疗患者占42.9%。介入治疗组患者GOSE评分ge;4.00分的比率、平均秩均明显高于手术治疗组（91.7％ VS 78.1％；39.38 VS 26.62）；然而其再出血发生率明显降低（4.67％VS18.13％）。结论：血管内弹簧圈栓塞治疗颅内动脉瘤性SAH效果较好，患者无残疾生存率、致残或死亡风险明显降低。 　　【关键词】动脉瘤 蛛网膜下腔出血 手术 介入 预后 　　【中图分类号】R730.5 【文献标识码】A 【文章编号】2095-1752（2014）03-0133-02 　　Prognosis Analysis of Subarachnoid Haemorrhage Resulting From the Ruptured Intracranial Aneurysms by Different Managements 　　【Abstract】Objective: To compare the prognosis of subarachnoid haemorrhage resulting from the ruptured intracranial aneurysms by surgical and endovascular coiling treatments. METHODS: Retrospectively reviewed clinical data of 56 patients admitted to this hospital for SAH secondary to ruptured intracranial aneurysm between January 2009 and July 2012, including 22 males and 34 females. Data of the Expanded Glasgow Outcome Scale scores (GOSE) and incidence of re-bleeding were collected for the two groups and subjected to relevant statistical analyses.Results: Of these 56 patients, 57.1% received surgical treatment, and 42.9% received endovascular coiling treatment. Significant differences association were found n GOSE (91.7％VS 78.1％; 39.38 VS 26.62) and incidence of re-bleeding(4.67％VS 18.13％) between the two different managements in 12 months. Conclusions: There is better disability-free survival and a risk reduction in dependency or death with endovascular coiling compared to surgery treatment. 　　【Key words】aneurysm subarachnoid hemorrhage surgery interventional prognosis 　　颅内动脉瘤破裂的蛛网膜下腔出血（Subarachnoid haemorrhage, SAH）是最严重的神经内外科急诊之一[1]。目前的治疗方案主要是外科手术夹闭与血管内弹簧圈栓塞两种。本研究回顾性分析了2009年1月～2012年7月本院神内外科收治的继发于颅内动脉瘤破裂的SAH患者临床资料，并分析治疗方案与患者预后的关系，以期找到适合本国颅内动脉瘤破裂患者的治疗标准。 　　1.临床资料与方法 　　1.1 研究对象