开颅夹闭与介入栓塞治疗前交通动脉瘤的风险及疗效的对比研究

发布时间：2018-01-12 03:05

  本文关键词：开颅夹闭与介入栓塞治疗前交通动脉瘤的风险及疗效的对比研究　出处：《大连医科大学》2017年硕士论文　论文类型：学位论文

  更多相关文章： 前交通动脉瘤 手术夹闭 脑血管痉挛 脑积水 低Na血症

【摘要】：目的:探讨手术夹闭术与介入栓塞术治疗前交通动脉瘤的临床效果。方法:从2015年1月至2017年1月于我院治疗的前交通动脉瘤患者中按入选标准随机筛选95例患者,并收集其临床资料,根据治疗方法分为手术组与介入组,对上述患者术后2周MMSE简易智能精神状态检查量表评分、GOS预后评分、脑积水、低Na血症及脑梗死发生率、术中动脉瘤破裂患者预后情况为评定效果及安全性指标进行回顾性分析并对其结果进行统计学分析。结果:手术组动脉瘤完全夹闭率与介入组完全填塞率无统计学差异(P0.05)。Hunt-HessⅠ及Ⅱ级患者定向力、记忆力或计算力、回忆力、注意力及语言功能介入组均优于手术组(P0.05);Hunt-HessⅢ-Ⅳ级患者定向力、记忆力或计算力、回忆力、注意力及语言功能手术组均优于介入组(P0.05)。手术组与介入组中Hunt-Hess Ⅰ及Ⅱ级患者脑室扩张或脑积水、低Na血症及脑梗死发生率均无明显差别(P0.05),Hunt-HessⅢ-Ⅳ级患者脑室扩张或脑积水及低Na血症及脑梗死发生率手术组均低于介入组(P0.05)。对于动脉瘤术中破裂患者的预后,手术组明显优于介入组(P0.05)。Hunt-HessⅢ-Ⅳ级患者GOS预后评分良好率手术组优于介入组(P0.05)。结论1.就处理前交通动脉瘤的成功率而言,手术夹闭术与介入栓塞术均是治疗前交通动脉瘤的有效手段。2.开颅手术夹闭术在应对和控制术中前交通脉动脉瘤的破裂方面较介入栓塞术更具优势。3.对于Hunt-HessⅢ-Ⅳ的患者,前交通动脉瘤手术夹闭术可降低术后并发症的发生率,故如患者能耐受手术,优先考虑行开颅夹闭术。4.对于Hunt-HessⅠ-Ⅱ的前交通动脉瘤患者介入栓塞术在保护患者认知功能方面优于手术夹闭术。
[Abstract]:Objective: to investigate the clinical effect of surgical clipping and interventional embolization in the treatment of anterior communicating aneurysm. From January 2015 to January 2017, 95 patients with anterior communicating aneurysm treated in our hospital were randomly selected according to the inclusion criteria. The clinical data were collected and divided into operation group and interventional group according to the treatment methods. The MMSE mini-mental state examination scale was used to evaluate the prognosis and hydrocephalus of the above patients 2 weeks after operation. The incidence of hyponatremia and cerebral infarction. The prognosis of patients with ruptured aneurysm during operation was analyzed retrospectively and the results were statistically analyzed. There was no significant difference between the complete occlusion rate of aneurysms in the operation group and the complete tamponade rate in the interventional group (. P0.05, Hunt-Hess grade 鈪，

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