血管内微导管介入治疗与夹闭手术治疗脑动脉瘤的临床效果比较

摘要

目的 探讨血管内微导管介入治疗与夹闭手术治疗脑动脉瘤的不良反应及临床效果差异.方法选择2015年1月至2016年12月经过临床和实验室确诊的脑动脉瘤患者92例,根据数字表法随机分为A组和B组,每组各46例.A组患者行血管介入治疗,B组采取手术夹闭治疗.对两组患者术后不良反应发生率、动脉瘤栓塞程度、恢复情况、凝血指标以及生活质量等进行比较分析.结果 B组手术治疗栓塞效果优于A组患者,差异有统计学意义(P<0.05).但B组术后病死率高于A组,差异有统计学意义(P<0.05).两组患者不良反应的发生率、治疗后恢复效果差异无统计学意义(P>0.05).术后12个月随访中发现,A组的复发率显著高于B组(P<0.05).A组患者的血小板计数、D-二聚体显著高于B组,差异有统计学意义(P<0.05).与B组比较,A组术中出血量较少,术后住院时间较短,生活质量也显著高于B组,但A组的手术时间显著高于B组,差异有统计学意义(P<0.05).结论 与夹闭手术比较,血管介入术的栓塞效果较差、复发率高,但是其能显著改善患者的生活质量,以及具有创伤小、恢复快等优点.%Objective To investigate the differences of clinical effects of endovascular micro catheter inter-ventional therapy and clipping surgery in patients with cerebral aneurysms.Methods A total of 92 patients were selected as the subjects,who were diagnosed as cerebral aneurysm by clinical and laboratory diagnosis from January 2015 to December 2016.According to table of random number,patients were divided into A group(micro catheter interventional therapy)and B group(clipping surgery),46 cases in each group.The in-cidence of adverse reactions,embolism degree,recovery,coagulation index and quality of life in the two groups were compared and analyzed.Results The embolization effect of B group was significantly better than the A group(P<0.05).But mortality rate of B group was significantly higher than that of A group(P<0.05). There was no significant difference in the incidence of adverse effects and effectiveness in two groups(P>0.05).After 12 months of treatment,the rate of recurrence of A group was significantly higher than that of B group(P<0.05).Platelet count and D-dimer of A group were significantly higher than that of the B group (P<0.05).And the haemorrhage and hospitalization time of A group were significantly lower than that of B group(P<0.05),and the quality of life of A group was significantly higher than that of B group(P<0.05), but the operative time of A group was significantly higher than that of B group(P<0.05).Conclusion Com-pared with clipping operation,effect of endovascular micro catheter interventional therapy is relatively worse, and the recurrence rate is higher,but it has the advantages of improving the quality of life of patients signifi-cantly,as well as less trauma and shorter recovery.