手术夹闭和血管内介入治疗颅内宽颈动脉瘤临床对比分析.docVIP

手术夹闭和血管内介入治疗颅内宽颈动脉瘤临床对比分析 　　【摘要】 目的 观察手术夹闭与血管内介入治疗颅内宽颈动脉瘤的临床疗效。方法 58例颅内宽颈动脉瘤患者随机分为手术夹闭组和血管介入组， 各29例， 分别给予手术夹闭和血管内介入治疗， 观察两组患者治疗疗效。结果 血管介入组血管完全闭塞率为86.21%， 显著低于手术夹闭组的100.00%（P0.05）；血管介入组住院时间短于手术夹闭组， 日常生活活动能力（ADL）评分高于手术夹闭组， 神经功能缺损评分（NIHSS评分）低于手术夹闭组， 差异均有统计学意义（P0.05）；血管介入组术后意识障碍、活动肢体障碍、动脉瘤再出血及胸积水发生率均显著低于手术夹闭组， 差异均有统计学意义（P0.05）。结论 与手术夹闭相比， 血管内介入治疗颅内宽颈动脉瘤具有远期疗效好、并发症少等优点， 值得临床推广应用。 　　【关键词】 颅内宽颈动脉瘤；手术夹闭；血管内介入 　　DOI：10.14163/j.cnki.11-5547/r.2015.16.015 　　【Abstract】 Objective To observe the clinical effect of surgical clipping and intravascular intervention in the treatment of intracranial wide-necked aneurysms. Methods A total of 58 patients with intracranial wide-necked aneurysms were randomly divided into surgical clipping group and intravascular intervention group， with 29 cases in each group. They respectively received surgical clipping and intravascular intervention for treatment， and their curative effects were observed. Results The total vascular obliteration rate was 86.21% in the intravascular intervention group， which was lower than 100.00% in the surgical clipping group （P0.05）. The intravascular intervention group had shorter hospital stay， higher activities of daily living （ADL） score， and lower national institutes of health stroke scale （NIHSS） score than the surgical clipping group， and their differences all had statistical significance （P0.05）. The intravascular intervention group had much lower incidences of postoperative disturbance of consciousness and limb movement， rehaemorrhagia of aneurysms， and hydrothorax than the surgical clipping group， and their differences all had statistical significance （P0.05）. Conclusion Compared with surgical clipping， intravascular intervention has advantages as good long-term effect and few complications， and this method is worth clinical promotion and application. 　　【Key words】 Intracranial wide-necked aneurysms； Surgical clipping； Intravascular intervention 　　颅内动脉瘤是临床常见的一种后天性脑血管疾病， 颅内动脉壁膨出、血液动力学冲击是引起颅内血管瘤的共同因素[1]