CAJ | 학술논문

目的：评价开颅夹闭与血管内栓塞治疗破裂性大脑中动脉瘤的早期疗效。方法对我科收治的破裂性大脑中动脉瘤患者，随机分为两组，A组（21例）予开颅夹闭术， B组（17例）予血管内栓塞术；比较两组的早期疗效。结果两组术前Hunt-Hess分级、年龄、性别无明显差异（ P＞0．05）。住院时间、术后脑梗死发生率、死亡率无明显差异（P＞0．05）；术后一月改良Rankin评分差异显著（P＜0．05）。 A组无死亡病例；B组1例血管内栓塞术中动脉瘤破裂死亡，1例术后大面积脑梗死死亡。结论破裂性大脑中动脉瘤开颅动脉瘤夹闭术后早期患者的症状改善状况优于血管内栓塞术，考虑原因为开颅夹闭术清除了动脉瘤周围的血肿，持续外引流蛛网膜下腔的积血及血性脑脊液。
목적：평개개로협폐여혈관내전새치료파렬성대뇌중동맥류적조기료효。방법대아과수치적파렬성대뇌중동맥류환자，수궤분위량조，A조（21례）여개로협폐술， B조（17례）여혈관내전새술；비교량조적조기료효。결과량조술전Hunt-Hess분급、년령、성별무명현차이（ P＞0．05）。주원시간、술후뇌경사발생솔、사망솔무명현차이（P＞0．05）；술후일월개량Rankin평분차이현저（P＜0．05）。 A조무사망병례；B조1례혈관내전새술중동맥류파렬사망，1례술후대면적뇌경사사망。결론파렬성대뇌중동맥류개로동맥류협폐술후조기환자적증상개선상황우우혈관내전새술，고필원인위개로협폐술청제료동맥류주위적혈종，지속외인류주망막하강적적혈급혈성뇌척액。
Objective To evaluate the curative effect adopting neurosurgical clipping and endovascular embolization for the patients with ruptured middle cerebral artery aneurysm .Methods The clinical data of the patients with ruptured middle cerebral artery aneurysm operated by our department ,including 21 cases ( group A ) of neurosurgical clipping and 17 cases ( group B ) of endovascular embolization .The curative effects were compared between two groups .Results There was no significant diference in the preoperative Hunt-Hess classification ,age and gender between two groups ( P>0 .05 ) .There was no significant diference in the length of stay ,the rates of postoperative cerebral infarction , mortality between two groups ( P>0 .05 ) , but postoperative modified Rankin Scale score were significantly higher in group A than those in group B (P<0.05).No patient died in group A and two patients died in group B .Conclusions The method that adopt neurosurgical clipping has a significantly better curative effect of earlier period than endovascular embolization , maybe the neurosurgical clipping can clear hematoma surrounding aneurysm and drainage bloody cerebrospinal fluid .