介入栓塞术与开颅夹闭术治疗后交通破裂动脉瘤的疗效与安全性比较(1)
【摘要】 目的 分析介入栓塞術和开颅夹闭术治疗后交通破裂动脉瘤的疗效与安全性。方法 80例后交通破裂动脉瘤患者， 根据治疗方法的不同分为栓塞组和夹闭组， 各40例。栓塞组行介入栓塞术治疗， 其中22例采用单纯弹簧圈治疗， 设为弹簧圈组;18例采用支架辅助弹簧圈治疗， 设为支架组。夹闭组行开颅夹闭术治疗。对比栓塞组和夹闭组并发症发生情况， 对比栓塞组中支架组、弹簧圈组与夹闭组病死率、复发率、术后1个月及6个月改良Rankin量表(mRS)评分。结果 栓塞组并发症发生率5.00%低于夹闭组的25.00%， 差异具有统计学意义(P<0.05)。支架组、弹簧圈组、夹闭组病死率分别为5.56%、4.55%、2.50%， 支架组、弹簧圈组、夹闭组病死率组间两两比较， 差异均无统计学意义(P>0.05);支架组、弹簧圈组、夹闭组复发率分别为0、27.27%、10.00%， 支架组与夹闭组、弹簧圈组与夹闭组复发率比较， 差异均无统计学意义(P>0.05);支架组复发率低于弹簧圈组， 差异具有统计学意义(P<0.05)。支架组、弹簧圈组、夹闭组术后1个月mRS评分0～2分比例分别为88.89%、81.82%、87.50%， 术后6个月mRS评分0～2分比例分别为88.89%、90.91%、92.50%， 支架组、弹簧圈组、夹闭组术后1个月及6个月mRS评分0～2分比例组间两两比较， 差异均无统计学意义(P>0.05)。结论 介入栓塞术与开颅夹闭术在后交通破裂动脉瘤治疗中均有良好疗效， 前者并发症发生率较低， 但前者中单纯弹簧圈栓塞的复发率偏高， 两种术式在近期和远期预后上无显著差异。
【关键词】 介入栓塞术;开颅夹闭术;后交通动脉瘤破裂;疗效
DOI：10.14163/j.cnki.11-5547/r.2020.09.006
【Abstract】 Objective To analyze the efficacy and safety of interventional embolization and craniotomy for ruptured posterior communicating artery aneurysm. Methods A total of 80 patients with ruptured posterior communicating artery aneurysm were divided by different treatment methods into embolization group and clamping group， with 40 cases in each group. Embolization group was treated by interventional embolization， of which 22 cases treated with a simple coil as the coil group， and 18 cases treated by a stent-assisted coil as the stent group. Clamping group was treated by craniotomy. The occurrence of complications was compared between the two groups. The mortality rate， recurrence rate， and modified Rankin scale (mRS) scores at 1 and 6 months after operation were compared in stent group， coil group and the clamping group. Results The incidence of complications 5.00% in embolization group was lower than 25.00% in clamping group， and the difference was statistically significant (P<0.05). The mortality rate of stent group， coil group and clamping group were 5.56%， 4.55% and 2.50% respectively. There was no statistically significant difference in mortality rate between every two groups of stent group， coil group and the clamping group (P>0.05). The recurrence rate of stent group， coil group and the clamping group were 0， 27.27% and 10.00% respectively. There was no significant difference in recurrence rate between stent group and clamping group， coil group and clamp group (P>0.05). The recurrence rate of stent group was lower than that of coil group， and the difference was statistically significant (P<0.05). At 1 month after operation， the ratio of mRS score 0-2 points of stent group， coil group and clamping group were 88.89%， 81.82% and 87.50% respectively， which were 88.89%， 90.91% and 92.50% respectively at 6 months after operation. There was no statistically significant difference in ratio of mRS score 0-2 points at 1 and 6 months after operation between every two groups of stent group， coil group and the clamping group (P>0.05). Conclusions Interventional embolization and transcranial clipping are both effective in the treatment of ruptured posterior communicating artery aneurysm. The incidence of complications in the former is low， but the recurrence rate of simple coil embolization in the former is high. There is no significant difference in the short-term and long-term prognosis between the two methods., http://www.100md.com(罗妙泉)
【关键词】 介入栓塞术;开颅夹闭术;后交通动脉瘤破裂;疗效
DOI：10.14163/j.cnki.11-5547/r.2020.09.006
【Abstract】 Objective To analyze the efficacy and safety of interventional embolization and craniotomy for ruptured posterior communicating artery aneurysm. Methods A total of 80 patients with ruptured posterior communicating artery aneurysm were divided by different treatment methods into embolization group and clamping group， with 40 cases in each group. Embolization group was treated by interventional embolization， of which 22 cases treated with a simple coil as the coil group， and 18 cases treated by a stent-assisted coil as the stent group. Clamping group was treated by craniotomy. The occurrence of complications was compared between the two groups. The mortality rate， recurrence rate， and modified Rankin scale (mRS) scores at 1 and 6 months after operation were compared in stent group， coil group and the clamping group. Results The incidence of complications 5.00% in embolization group was lower than 25.00% in clamping group， and the difference was statistically significant (P<0.05). The mortality rate of stent group， coil group and clamping group were 5.56%， 4.55% and 2.50% respectively. There was no statistically significant difference in mortality rate between every two groups of stent group， coil group and the clamping group (P>0.05). The recurrence rate of stent group， coil group and the clamping group were 0， 27.27% and 10.00% respectively. There was no significant difference in recurrence rate between stent group and clamping group， coil group and clamp group (P>0.05). The recurrence rate of stent group was lower than that of coil group， and the difference was statistically significant (P<0.05). At 1 month after operation， the ratio of mRS score 0-2 points of stent group， coil group and clamping group were 88.89%， 81.82% and 87.50% respectively， which were 88.89%， 90.91% and 92.50% respectively at 6 months after operation. There was no statistically significant difference in ratio of mRS score 0-2 points at 1 and 6 months after operation between every two groups of stent group， coil group and the clamping group (P>0.05). Conclusions Interventional embolization and transcranial clipping are both effective in the treatment of ruptured posterior communicating artery aneurysm. The incidence of complications in the former is low， but the recurrence rate of simple coil embolization in the former is high. There is no significant difference in the short-term and long-term prognosis between the two methods., http://www.100md.com(罗妙泉)