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目的探讨夹闭和栓塞治疗颅内动脉瘤对蛛网膜下腔出血脑血管痉挛的影响。方法 106例颅内动脉瘤破裂导致蛛网膜下腔出血患者,根据治疗方法的不同分为夹闭组(66例,给予瘤颈夹闭术)和栓塞组(40例,给予血管内栓塞术),对比效果。结果夹闭组血管痉挛程度高于栓塞组,症状性痉挛例数多于栓塞组(P<0.05)。两组动脉瘤大小、Fisher分级、Hunt和Hess分级比较差异均具有统计学意义(P<0.05)。夹闭组监护时间(6.12±4.86)d、住院时间(11.00±8.45)d均长于栓塞组的(2.99±1.28)、(7.01±5.84)d(P<0.05)。结论患者的入院时间、动脉瘤大小,Fisher分级以及Hunt和Hess分级是影响治疗颅内动脉瘤破裂导致蛛网膜下腔出血脑血管痉挛的主要因素,与夹闭治疗相比,栓塞治疗效果更好。
Objective To investigate the effects of clipping and embolization on intracranial aneurysms on cerebral vasospasm in patients with subarachnoid hemorrhage. Methods One hundred and six patients with intracranial aneurysm rupture resulted in subarachnoid hemorrhage. According to the different treatment methods, the patients were divided into two groups: occlusion group (66 cases, tumor neck clipping) and embolization group (40 cases, endovascular embolization) , Contrast effect. Results The degree of vasospasm in the occlusion group was higher than that in the embolization group, and the number of symptomatic spasms was more than that in the embolization group (P <0.05). Two groups of aneurysm size, Fisher classification, Hunt and Hess grading differences were statistically significant (P <0.05). The duration of monitoring (6.12 ± 4.86) d and hospital stay (11.00 ± 8.45) days in the occlusion group were longer than those in the embolization group (2.99 ± 1.28, 7.01 ± 5.84) days (P <0.05). Conclusions The time of admission, size of aneurysm, Fisher’s grade and Hunt and Hess grading are the main factors influencing cerebral vasospasm of subarachnoid hemorrhage caused by intracranial aneurysm rupture, and embolization treatment is better than clipping treatment .