血管内介入栓塞术与开颅夹闭术治疗脑动脉瘤临床分析

发布时间：2018-04-27 10:23

本文选题：脑动脉瘤 + 开颅夹闭术　；参考：《延边大学》2014年硕士论文

【摘要】：目的：目前对于脑动脉瘤破裂有两种规范的治疗手段,分别为血管内介入栓塞术与开颅手术夹闭动脉瘤。本论文目的在于对上述两种治疗方法进行对比研究,分析采用两种治疗方法的异同点,如住院时间,手术时间,手术类型,住院费用,相关并发症等方面的差异及原因,为临床治疗提供参考。方法：经判定两种治疗方式均无禁忌证、均为适应症的患者,分成两组：开颅手术治疗组(A组)和血管内介入栓塞组(B组),记录患者入院时的病情,Hunt分级、出血次数、动脉瘤(出血)部位,记录患者的治疗情况与病情发展结果。随访观察1年,,记录患者手术时间,住院时间,手术部位患者恢复情况及并发症情况等,并采用Glasgow结果评分评价。结果：开颅夹闭术组(A组)手术操作时间为2.97±0.601.9～4.2)小时,血管内介入栓塞术组(B组)手术操作时间为2.13±0.61(1.1～3.5)小时,P0.01。开颅夹闭术组(A组)住院天数为1.2±2.6(12～22)天,血管内介入组(B组)住院天数为10.6±2.1(7～15)天,两组比较采用t检验,P0.01。通过数据我们可见动脉瘤介入栓塞治疗手术时间短,减少住院周期,均优于开颅手术组。开颅手术夹闭治疗组：平均年龄为52.8±9.3岁；血管内介入栓塞组：平均年龄为63.5±11.9岁,P0.01。在前交通动脉瘤、椎基底动脉瘤手术中介入组应用较开颅组多,均P0.01,后交通动脉瘤开颅手术组应用较多,P0.01。脑动脉瘤介入栓塞术治疗比较开颅夹闭组住院时间短,减少住院周期,介入组术后随访远期治疗效果好。以介入组平均年龄较开颅组高,并且介入组仅仅在后交通动脉瘤应用较少,在椎基底动脉脑动脉瘤手术开颅夹闭术做不了的手术主要以介入栓塞术为主要治疗手段,我们认为介入组适用性更广。。结论： 1.血管内介入栓塞术适用范围广。 2.脑动脉瘤手术首选血管内介入栓塞术。 3脑动脉瘤血管内栓塞术远期治疗效果优于开颅夹闭术。
[Abstract]:Objective: at present, there are two kinds of standard treatment for ruptured cerebral aneurysms, one is endovascular embolization and the other is clipping the aneurysm after craniotomy. The purpose of this paper is to compare the two treatment methods, and analyze the differences and reasons of the two methods, such as hospitalization time, operation time, operation type, hospitalization cost, related complications and so on. To provide a reference for clinical treatment. Methods: the patients with no contraindication and indications were divided into two groups: craniotomy group (group A) and endovascular embolization group (group B). The patients were divided into two groups: group A (group A) and group B (group B). Aneurysm (bleeding) site, record the patient's treatment and the development of the disease. All patients were followed up for 1 year to record the time of operation, the time of hospitalization, the condition of recovery and complications of the patients at the site of operation, and to evaluate the results of Glasgow. Results: the operative time of group A was 2.97 卤0.601.9 卤4.2 hours, and that of group B was 2.13 卤0.61 卤1.11 卤3.5) hours (P 0.01). The days of hospitalization in group A and group B were 1.2 卤2.6 and 10.6 卤2.1 ~ 7 ~ 15) days respectively. T test was used to compare the two groups (P < 0.01). According to the data we can see that the interventional embolization of aneurysms is better than the craniotomy group because of the shorter operation time and less hospitalization period. The mean age was 52.8 卤9.3 years in clipping group and 63.5 卤11.9 years old in endovascular embolization group (P 0.01). In the anterior communicating artery aneurysm, the interventional group was more than the craniotomy group in the operation of vertebrobasilar aneurysm (P0.01), and the posterior communicating aneurysm was more used in the craniotomy group (P0.01). The interventional embolization of cerebral aneurysm was more effective than that of the clipping group. The average age of the interventional group was higher than that of the craniotomy group, and the interventional group was only used less in the posterior communicating artery aneurysm. We think the intervention group is more applicable. Conclusion: 1. Endovascular embolization is widely used. 2. Endovascular embolization is the first choice in the operation of cerebral aneurysm. 3 the long-term therapeutic effect of endovascular embolization for cerebral aneurysms was better than that of open-craniotomy.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.41

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