血管内及开颅手术治疗颅内宽颈动脉瘤对比研究

发布时间：2018-05-16 23:29

本文选题：宽颈动脉瘤 + 支架辅助　；参考：《广西医科大学》2014年硕士论文

【摘要】：目的：探讨宽颈动脉瘤破裂出血超早期诊疗方法、安全性及预后。方法：回顾性分析我科2010年1月到2013年12月之间，使用支架辅助栓塞或开颅夹闭治疗超早期（48h）颅内宽颈动脉瘤破裂出血50例，动脉瘤55个，比较观测两组手术相关并发症、复发率及预后。动脉瘤栓塞程度采用Raymond分级，预后采取改良mRS评分，0～2分为良好，，3～6分为不良。结果：用支架辅助栓塞组28例患者共31个动脉瘤，术后良好率(82.1%)，开颅夹闭组22例患者共24个动脉瘤，术后良好率(81.8%)。两组在治疗效果及预后上无统计学意义。开颅夹闭组在术后闭塞率上优于支架辅助栓塞（P0.05），开颅夹闭组在手术相关并发症较支架辅助栓塞发生率高，但两组差别无统计学意义（P0.05）。支架辅助栓塞复发率较开颅夹闭组高，但两组差别无统计学意义；开颅夹闭组平均住院日较支架辅助栓塞组长，两组有统计学意义（P0.05）。结论：手术开颅夹闭和支架辅助栓塞均为治疗颅内宽颈动脉瘤的有效方法。手术夹闭宽颈动脉瘤致密栓塞率优于支架辅助栓塞；支架辅助栓塞组宽颈动脉瘤复发率较手术夹闭组高，但两组差别无统计学意义；支架辅助栓塞组相对于手术夹闭组手术相关并发症发生率低，创伤小、恢复快。
[Abstract]:Objective: to explore the method, safety and prognosis of super-early diagnosis and treatment for ruptured hemorrhage of wide-necked aneurysms. Methods: from January 2010 to December 2013, 50 patients (55 aneurysms) with ruptured intracranial wide-necked aneurysms were treated with stent-assisted embolization or craniotomy for 48 h. The complications associated with operation were compared between the two groups. Recurrence rate and prognosis. The degree of embolism of aneurysm was classified by Raymond grade, and the prognosis was improved by mRS score. Results: there were 31 aneurysms in 28 patients in the stent-assisted embolization group, the good rate was 82.1%, and 24 aneurysms in 22 patients in the craniotomy clipping group. The good rate was 81.8%. There was no significant difference in therapeutic effect and prognosis between the two groups. The rate of occlusion in the open clipping group was better than that in the stent assisted embolization group (P 0.05). The incidence of operative complications in the craniotomy clipping group was higher than that in the stent assisted embolization group, but the difference between the two groups was not statistically significant (P 0.05). The recurrence rate of stent assisted embolization was higher than that of open clipping group, but there was no significant difference between the two groups. Conclusion: surgical clipping and stent-assisted embolization are effective methods for the treatment of intracranial wide-necked aneurysms. The recurrence rate of wide carotid aneurysm in the stent assisted embolization group was higher than that in the operation clipping group, but there was no significant difference between the two groups. Compared with the clipping group, the stent-assisted embolization group had lower incidence of operative complications, less trauma and faster recovery.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.41

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