中外医学研究
中外醫學研究
중외의학연구
CHINESE AND FOREIGN MEDICAL RESEARCH
2013年
31期
7-8,9
,共3页
颅内动脉瘤%开颅夹闭%介入栓塞
顱內動脈瘤%開顱夾閉%介入栓塞
로내동맥류%개로협폐%개입전새
Intracranial aneurysm%Craniotomy clipping%Endovascular embolization
目的：分析颅内动脉瘤开颅显微夹闭和血管内介入栓塞治疗颅内动脉瘤的疗效。方法：回顾性分析性笔者所在医院2009年1月1日-2011年12月29日颅内动脉瘤患者495例的临床资料，其中行开颅夹闭223例，介入栓塞272例。Hunt-Hess分级：夹闭组Ⅰ~Ⅲ级165例，Ⅳ~Ⅴ级58例；栓塞组Ⅰ~Ⅲ级198例，Ⅳ~Ⅴ级74例。两组Hunt-Hess分级比较，差异无统计学意义(P>0.05)。造影观察栓塞程度，术后随访3个月和1年时的GOS评分评估、并发症的发生率及住院时间。结果：术中造影瘤颈完全闭塞：夹闭组214例(95.96%)，栓塞组208例(76.47%)。预后良好(GOS 4~5分)：夹闭组198例(88.79%)，栓塞组231例(84.93%)。并发症：夹闭组术后脑梗死24例(10.76%)，术后脑积水21例(9.42%)；栓塞组术后脑梗死35例(12.87%)，术后脑积水37例(13.60%)。住院时间：夹闭组(15.0±7.5)d，栓塞组(8.0±4.2)d。结论：开颅显微夹闭和血管内介入栓塞对治疗颅内动脉瘤均疗效显著，各有优势。
目的：分析顱內動脈瘤開顱顯微夾閉和血管內介入栓塞治療顱內動脈瘤的療效。方法：迴顧性分析性筆者所在醫院2009年1月1日-2011年12月29日顱內動脈瘤患者495例的臨床資料，其中行開顱夾閉223例，介入栓塞272例。Hunt-Hess分級：夾閉組Ⅰ~Ⅲ級165例，Ⅳ~Ⅴ級58例；栓塞組Ⅰ~Ⅲ級198例，Ⅳ~Ⅴ級74例。兩組Hunt-Hess分級比較，差異無統計學意義(P>0.05)。造影觀察栓塞程度，術後隨訪3箇月和1年時的GOS評分評估、併髮癥的髮生率及住院時間。結果：術中造影瘤頸完全閉塞：夾閉組214例(95.96%)，栓塞組208例(76.47%)。預後良好(GOS 4~5分)：夾閉組198例(88.79%)，栓塞組231例(84.93%)。併髮癥：夾閉組術後腦梗死24例(10.76%)，術後腦積水21例(9.42%)；栓塞組術後腦梗死35例(12.87%)，術後腦積水37例(13.60%)。住院時間：夾閉組(15.0±7.5)d，栓塞組(8.0±4.2)d。結論：開顱顯微夾閉和血管內介入栓塞對治療顱內動脈瘤均療效顯著，各有優勢。
목적：분석로내동맥류개로현미협폐화혈관내개입전새치료로내동맥류적료효。방법：회고성분석성필자소재의원2009년1월1일-2011년12월29일로내동맥류환자495례적림상자료，기중행개로협폐223례，개입전새272례。Hunt-Hess분급：협폐조Ⅰ~Ⅲ급165례，Ⅳ~Ⅴ급58례；전새조Ⅰ~Ⅲ급198례，Ⅳ~Ⅴ급74례。량조Hunt-Hess분급비교，차이무통계학의의(P>0.05)。조영관찰전새정도，술후수방3개월화1년시적GOS평분평고、병발증적발생솔급주원시간。결과：술중조영류경완전폐새：협폐조214례(95.96%)，전새조208례(76.47%)。예후량호(GOS 4~5분)：협폐조198례(88.79%)，전새조231례(84.93%)。병발증：협폐조술후뇌경사24례(10.76%)，술후뇌적수21례(9.42%)；전새조술후뇌경사35례(12.87%)，술후뇌적수37례(13.60%)。주원시간：협폐조(15.0±7.5)d，전새조(8.0±4.2)d。결론：개로현미협폐화혈관내개입전새대치료로내동맥류균료효현저，각유우세。
Objective:To analyze the effects of craniotomy clipping and endovascular embolization in the treatment of intracranial aneurysms.Method:The clinical data of 495 cases who were treated in our hospital from Jan 2009 to Dec 2011 were analyzed retrospectively,includings 223 cases the group of craniotomy microsurgical clipping(CMC),272 cases in the group of Endovascular embolization(EE).Hunt and Hess grade:Craniotomy microsurgical clipping(I-Ⅲ:165 cases,Ⅳ-Ⅴ:58 cases),Endovascular embolization(Ⅰ-Ⅲ:198 cases,Ⅳ-Ⅴ:74 cases).There were no significant differences in the Hunt-Hess grade between two groups(P>0.05).Some indicators of the intracranial aneurysms were observed,includes the embolization degree,the recovery evaluation according to the GOS score after postoperative 3 months and 1 year,the complications,and the hospitalization time.Result:The rate of aneurysmal obliteration in CMC was 95.96%(214 cases),which in the EE was 76.47%(208 cases).Favorable prognosis(GOS 4-5):There were 198 cases in CMC(88.79%),there were 231 cases in EE(84.93%). Complications:The rate of postoperative cerebral infarction in CMC was 10.76%(24 cases),which in EE was 12.87%(35 cases).The rate of postoperative hydrocephalus in CMC was 9.42%(21 cases),which in EE was 13.60%(37 cases).The average hospitalization time in CMC was (15.0±7.5)d,which in EE was (8.0±4.2)d.Conclusion:Both craniotomy clipping and endovascular embolization have significant efficacy in the treatment of intracranial aneurysms,and two ways have their own advantages.
