开颅夹闭治疗颅内前循环破裂动脉瘤疗效剖析.docVIP

开颅夹闭治疗颅内前循环破裂动脉瘤疗效剖析 　　[摘要] 目的 探讨开颅夹闭治疗颅内前循环破裂动脉瘤疗效。方法 整群选取2012年7月―2015年2月在医院收治的72例前循环动脉瘤破裂的患者，将其随机分为开颅夹闭组36例和介入组36例，对治疗后两组患者的格拉斯哥（GOS）预后的评分以及术后不良事件进行分析。结果 两组在改善患者预后方面，差异无统计学意义（P0.05）；在手术复发率方面，开颅组为2.78%，介入组为19.44%，经统计，差异有统计学意义（P0.05）。结论 开颅夹闭术和介入术都可明显改善患者的预后，但开颅手术的复发率比较低。 　　[关键词] 开颅夹闭；颅内前循环；动脉瘤 　　[中图分类号] R651.2 [文献标识码] A [文章编号] 1674-0742（2016）01（b）-0035-03 　　Analysis of the Effect of Craniotomy Clipping in the Treatment of Ruptured Intracranial Aneurysms of the Anterior Circulation 　　GUO Ji-feng1， HUO Nan-nan2， SHAN Xian-min1 　　1. Emergency Department， The Third People’s Hospital of Dalian， Dalian， Liaoning Province， 116033 China； 　　2. Department of Vascular Surgery， Dalian University Affiliated Xinhua Hospital， Dalian， Liaoning Province， 116021 China 　　[Abstract] Objective To investigate the effect of craniotomy clipping in the treatment of ruptured intracranial aneurysms of the anterior circulation. Methods 72 cases with ruptured intracranial aneurysms of the anterior circulation admitted in hospital from July 2012 to February 2015 were selected and randomly divided into the craniotomy clipping group （36 cases） and the intervention group（36 cases）. The GOS and incidence of postoperative adverse events of the two groups were analyzed after treatment. Results The difference in the prognosis between the two groups was not statistically significant， P0.05. The incidence of recurrent rate was 2.78% in the craniotomy clipping group and 19.44% in the intervention group， the difference between the two groups was statistically significant， P0.05. Conclusion Both craniotomy clipping and interventional procedure can significantly improve the prognosis of the patients， but the recurrence rate of the former is lower. 　　[Key words] Craniotomy clipping； Intracranial anterior circulation； Aneurysm 　　近几年来，随着科技的进步和经济的高速发展，给人们带来的社会生活压力也随之增大，发现动脉瘤的患者以日趋增多。动脉瘤是一种破裂风险较大的、死亡率非常高的潜在危险因素，而且大多位于前循环部位，蛛网膜下腔出血80%的病因都是动脉瘤破裂导致。传统对颅内前循环动脉瘤破裂的处理主要是开颅手术清除脑内血块和积血，防止再出血，预防感染[1]。目前主要以开颅夹闭治