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目的分析对比显微外科夹闭手术与血管内介入治疗颅内动脉瘤的临床效果。方法 86例颅内动脉瘤患者,将其随机分为治疗组(43例)和实验组(43例),治疗组患者行显微外科夹闭手术,实验组患者行血管内介入治疗,对此两组患者格拉斯哥预后量表(GOS量表)疗效评定、并发症及住院时间情况等进行比较。结果经治疗,治疗组术后轻残、重残、恢复良好、植物生存、死亡等GOS量表疗效和实验组对比差异无统计学意义(P>0.05)。治疗组出现8例并发症,占18.60%,其中术后脑积水2例,术后肺部感染3例,颅内感染并发热3例。实验组出现7例并发症,占16.28%,其中血栓形成4例,经尿激酶150万U导管注入后,血栓消失。血管痉挛3例,经抗凝、抗痉挛及扩容治疗后于72 h内完全恢复,术后患者在1周内一侧肢体肌力恢复至4级,两组并发症对比差异无统计学意义(χ2=0.11,P>0.05)。结论显微外科夹闭手术与血管内介入治疗颅内动脉瘤效果无显著差别,均能有效改善患者临床症状,减少并发症。应结合患者身体状况、动脉瘤部位和身体状况选择最佳治疗方案,进而提高患者生存率。
Objective To analyze the clinical effects of microsurgical clipping and endovascular interventional treatment of intracranial aneurysms. Methods Totally 86 patients with intracranial aneurysm were randomly divided into treatment group (43 cases) and experimental group (43 cases). The patients in the treatment group underwent microsurgical clipping and the patients in the experimental group received endovascular intervention. Two groups of Glasgow Outcome Scale (GOS scale) efficacy evaluation, complications and hospitalization time were compared. Results After treatment, there was no significant difference between the treatment group and the experimental group (P> 0.05). The treatment group showed 8 cases of complications, accounting for 18.60%, of which 2 cases postoperative hydrocephalus, postoperative pulmonary infection in 3 cases, intracranial infection and fever in 3 cases. Seven cases of complications occurred in the experimental group, accounting for 16.28%, of which thrombosis in 4 cases, urokinase 1.5 million U catheter infusion, the thrombus disappeared. Three cases of vasospasm recovered completely within 72 hours after anticoagulant, anticonvulsant and dilatation. The limb muscle strength of one limb recovered to grade 4 in one week after operation. There was no significant difference in complication between the two groups χ2 = 0.11, P> 0.05). Conclusion There is no significant difference between microsurgery and intravascular interventional treatment for intracranial aneurysm, which can effectively improve the clinical symptoms and reduce the complications. Should be combined with the patient’s physical condition, aneurysm site and physical condition to choose the best treatment, thereby improving patient survival.