手术夹闭与血管内介入治疗颅内宽颈动脉瘤临床对比分析.doc

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1、手术夹闭与血管内介入治疗颅内宽颈动脉瘤临床对比分析【摘耍】目的观察手术夹闭与血管内介入治疗颅内宽颈动脉瘤的临床疗效。方法58例颅内宽颈动脉瘤患者随机分为手术夹闭组和血管介入组，各29例，分别给予手术夹闭和血管内介入治疗，观察两组患者治疗疗效。结果血管介入组血管完全闭塞率为86.21%,显著低于手术夹闭组的100.00%（P<0.05）；血管介入组住院时间短于手术夹闭组，H常生活活动能力（ADL）评分高于手术夹闭组，神经功能缺损评分（NTHSS评分）低于手术夹闭组，差异均有统计学意义（P〈0・05）；血管介入组术后意识障碍、活动肢体障碍、

2、动脉瘤再出血及胸积水发生率均显著低于手术夹闭组，差异均有统计学意义（卩〈0.05）。结论与手术夹闭相比，血管内介入治疗颅内宽颈动脉瘤具有远期疗效好、并发症少等优点，值得临床推广应用。【关键词】颅内宽颈动脉瘤；手术夹闭；血管内介入DOT：10.14163/j.cnki.11-5547/r.2015.16.015[Abstract]ObjectiveToobservetheclinicaleffectofsurgicalclippingandintravascularinterventioninthetreatmentofintracran

3、ialwide-neckedaneurysms・MethodsAtotalof58patientswithintracranialwide一neckedaneurj^smswererandomlydividedintosurgicalclippinggroupandintravascularinterventiongroup,with29casesineachgroup.Theyrespectivelyreceivedsurgicalclippingandintravascularinterventionfortreatment,and

4、theircurativeeffectswereobserved.ResultsThetotalvascularobliterationratewas86.21%intheintravascularinterventiongroup,whichwas1owerthan100.00%inthesurgicalclippinggroup(P<0.05)・Theintravascularinterventiongrouphadshorterhospitalstay,higher且ctivitiesofdai1y1iving(ADL)score

5、,andlowernationalinstitutesofhealthstrokescale(NIHSS)scorethanthesurgicalclippinggroup,andtheirdifferencesallhadstatisticalsignificance(P<0.05)・Theintravascularinterventiongrouphadmuchlowerincidencesofpostoperativedisturbanceofconsciousnessand1imbmovement,rehaemorrhagiao

6、faneurysms,andhydrothoraxthanthesurgicalclippinggroup,andtheirdifferencesallhadstatisticalsignificance(卩〈0.05)•ConclusionComparedwithsurgicalclipping,intravascularinterventionhasadvantagesasgoodlong-termeffectaridfewcomplications,andthismethodisworthclinicalpromotionanda

7、pp1ication.[Keywords]Intracranialwide-neckedaneurysms；Surgicalclipping；Tntravasculariritervention颅内动脉瘤是临床常见的一种后天性脑血管疾病，颅内动脉壁膨出、血液动力学冲击是引起颅内血管瘤的共同因素[1]。颅内宽颈动脉瘤是指肿瘤绝対颈宽24mm的动脉瘤，一旦发生破裂出血，具有较高的致残率和致死率[2]o目前，对于颅内动脉瘤的治疗，主要方案为手术夹闭和血管内介入治疗，虽然医疗水平已有大幅度提高，但由于颅内动脉瘤形态特殊，治疗后仍有较高的并发症及

8、复发率。本研究观察了手术夹闭与血管内介入治疗颅内宽颈动脉瘤的临床疗效，并对手术效果及并发症情况进行了对比分析，旨在为临床治疗颅内宽颈动脉瘤提供一种可靠的临床依据，现报告如下。1资料与方法1.1一般资料选取2