摘要
目的:探究介入治疗与夹闭术治疗世界神经外科联盟(WFNS)高分级动脉瘤性蛛网膜下腔出血(a SAH)的临床疗效及安全性。方法:选取2011年4月-2015年4月本院收治的高分级a SAH患者79例作为研究对象,按照入院时间顺序分为对照组和观察组,对照组接受介入栓塞治疗,观察组接受手术夹闭治疗。比较两组患者Fisher分级、术后3个月预后情况及并发症发生率。结果:观察组Fisher分级Ⅱ级例数明显多于对照组,Ⅳ级例数明显少于对照组,比较差异均有统计学意义(P<0.05);观察组术后3个月格拉斯哥预后量表(GOS)评价中预后良好率为80.0%,明显高于对照组的59.0%,Barthel指数为(82.14±6.14),明显高于对照组的(69.45±6.77),比较差异均有统计学意义(P<0.05);观察组并发症发生率为2.5%,明显低于对照组的15.4%,比较差异有统计学意义(P<0.05)。结论:手术夹闭治疗高分级动脉瘤性蛛网膜下腔出血有较好的治疗效果,能有效清除颅内积血,改善神经功能预后,安全性较高,值得临床推广。
Objective：To explore the clinical efficacy and safety of interventional therapy and clipping treatment on patients with World Federation of Neurosurgical Societies（WFNS） high grade aneurysm subarachnoid hemorrhage.Method：A total of 79 patients with high-grade aneurysmal subarachnoid hemorrhage were selected in our hospital from April 2011 to April 2015 as the research objects,they were divided into the control group and the observation group according to the sequence of admission time.The control group received interventional embolization treatment and the observation group received clipping operation treatment.The Fisher classification,prognosis after 3 months of surgery and complication rate in two groups were compared.Result：The number of Fisher levelⅡin the observation group was significantly higher than the control group,and the number of Fisher level Ⅳ was significantly less than the control group,the differences were statistically significant（P〈0.05）.The GOS better prognosis rate after 3 months of surgery in the observation group was 80.0%,significantly higher than 59.0% of the control group,the Barthel index score of the observation group after 3 months of surgery was（82.14±6.14）,significantly higher than（ 69.45±6.77）of the control group,the differences were statistically significant（P〈0.05）.The complication rate of observation group was 2.5%,which was significantly lower than 15.4% of the control group,the difference was statistically significant（P〈0.05）.Conclusion：The clipping treatment of high-grade aneurysms subarachnoid hemorrhage has better therapeutic effect,can effectively remove the intracranial hemorrhage and improve the prognosis of nerve function,the safety is high,it is worth of clinical promotion.
出处
《中国医学创新》
CAS
2016年第15期12-15,共4页
Medical Innovation of China
关键词
介入栓塞
手术夹闭
高分级动脉瘤性蛛网膜下腔出血
对比研究
Interventional embolization
Surgical clipping
High-grade of aneurysms subarachnoid hemorrhage
Comparative study
