颅内动脉瘤手术夹闭和介入栓塞治疗对比分析.docVIP

颅内动脉瘤手术夹闭和介入栓塞治疗对比分析 　　摘要:目的 对比分析颅内动脉瘤在开颅手术夹闭与介入栓塞治疗两种方法的优缺点及临床效果和处理特点。 方法 回顾性分析51例颅内动脉瘤病人经开颅手术夹闭和介入栓塞治疗。动脉瘤破裂47例、未破裂4例;男14例、女37例;年龄20~74岁；手术夹闭27例、介入栓塞24例 。结果 手术夹闭痊愈23例，轻残2例，重残1例，死亡1例；介入栓塞痊愈21例，轻残2例，死亡1例。Hunt-Hces分级 Ⅲ级以下两组治疗结果无统计学差异。结论 手术夹闭和介入栓塞各有优缺点，应该相辅相成、互补应用。? 　　关键词 颅内动脉瘤 手术夹闭 介入栓塞 ?? 　　 　　Surgical Clipping or Interventional Embolization for the Treatment of Cerebral Aneurysm Rupture:A Clinical Analysis.Li He,Yu De-min, Peng Hua, et al.The Second peoples hospital of YiBin. YiBin SiChuan 644000,China.?? 　　【Abstract】Objective The aim of the present study was to investigate and compare the advantage, clinical outcome, and features of management between neurosurgical clipping and endovascular embolization for the treatment of intracranial aneurysms.Methods 51 patients who were treated for intracranial aneurysms with either neurosurgical clipping or endovascular embolization were recruited in this study. 47 of them with ruptured aneurysms and four with non-ruptured aneurysms, 14 males and 37 females, aged 20 to 74 years, 27 underwent surgical clipping and 24 underwent endovascular embolization.Results In the surgical clipping group, complete recovery was achieved in 23 cases, light disablement presented in two, severe disablement and death occurred in one each. In the endovascular embolization group, complete recovery was achieved in 21 cases, light disablement presented in two, and death occurred in one. There was no significant difference in Hunt-Hess evaluation between neurosurgical clipping and endovascular embolization in the treatment of intracranial aneurysms.Conclusion Neurosurgical clipping and endovascular embolization seem to be complementary for the treatment of intracranial aneurysms.? 　　【Key words】Intracranial aneurysms；Neurosurgical clipping； Endovascular embolization.?? 　　 　　颅内动脉瘤是一种危及生命的急性脑血管疾病。颅内动脉瘤易反复破裂出血，其致残率和病死率随出血的次数增加而增高。到目前为止颅内动脉瘤的介入栓塞及开颅手术夹闭动脉瘤是对脑动脉瘤最有效的治疗手段［1］。对颅内动脉瘤治疗上的两种方式的选择及相应适应症、手术时机的掌握，临床上仍存在着不同的看法。? 　　我科从2002年1月至2006年12月，收治5