摘要
目的:比较分析血管栓塞介入术与眶上外侧入路显微手术治疗前交通动脉瘤的效果。方法:对本院及市一院2014年1月~2017年1月收治的40例前交通动脉瘤患者病例资料进行回顾性分析,根据不同治疗方法将其分为介入组(血管栓塞介入)与显微组(眶上外侧入路显微镜夹闭),比较两组手术相关指标、术后并发症、术后6个月格拉斯哥预后(GOS)评分结果、认知功能障碍发生率及随访情况。结果:介入组手术时间(60.25±21.37)min,比显微组的(153.68±20.61)min显著短,手术成功率83.33%,比显微组的100.00%显著低,差异有统计学意义;两组住院时间、术后并发症发生率、术后半年预后良好率、认知功能障碍发生率及末次随访瘤颈残留、再出血率比较差异均无统计学意义。结论:眶上外侧入路显微手术夹闭相比血管栓塞成功率高,术后预后可能更好,但其手术时间显著长,血管栓塞介入相比显微手术对患者认知功能影响小,建议根据患者情况选择合适术式。
Objective To compare the effects of endovascular interventional embolization and supraorbital lateral microsurgery in the treatment of anterior communicating artery aneurysms. Methods The clinical data of 40 patients with anterior communicating artery aneurysms treated in our hospital from January 2014 to January 2017 were retrospectively analyzed. According to the different treatment methods, the patients were divided into intervention group(treated with endovascular interventional embolization) and microsurgery group(treated with supraorbital lateral microscopic clipping). The surgery related indexes, postoperative complications, the Glasgow outcome score(GOS), the incidence of cognitive impairment and follow-up were compared between the two groups. Results The surgical time of intervention group was significantly shorter than that of microsurgery group [(60.25±21.37) min vs(153.68±20.61) min], and the surgical success rate of surgery was significantly lower than that in microsurgery group(83.33% vs 100.00%). There was no significant difference between the two groups in hospitalization time, the incidence of postoperative complications, good and excellent rate of prognosis in six months after surgery, the incidence of cognitive impairment, the rate of residual tumor at the end of follow-up and rebleeding rate. Conclusion The successful rate of supraorbital lateral microscopic clipping is higher than that of endovascular interventional embolization, and the prognosis is better. The time of the former is significantly longer and the latter has less effect on cognitive function. Therefore, appropriate surgery should be chosen according to the actual conditions of patients.
出处
《湖南师范大学学报（医学版）》
2017年第6期175-178,共4页
Journal of Hunan Normal University(Medical Sciences)
关键词
前交通动脉瘤
血管栓塞介入
显微夹闭
眶上外侧入路
anterior communicating artery aneurysm
endovascular interventional embolization
microscopic clipping
supraorbital lateral approach
