本文關(guān)鍵詞：開顱夾閉與介入栓塞治療前交通動(dòng)脈瘤的風(fēng)險(xiǎn)及療效的對(duì)比研究　出處：《大連醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 前交通動(dòng)脈瘤 手術(shù)夾閉 腦血管痙攣 腦積水 低Na血癥

【摘要】：目的:探討手術(shù)夾閉術(shù)與介入栓塞術(shù)治療前交通動(dòng)脈瘤的臨床效果。方法:從2015年1月至2017年1月于我院治療的前交通動(dòng)脈瘤患者中按入選標(biāo)準(zhǔn)隨機(jī)篩選95例患者,并收集其臨床資料,根據(jù)治療方法分為手術(shù)組與介入組,對(duì)上述患者術(shù)后2周MMSE簡(jiǎn)易智能精神狀態(tài)檢查量表評(píng)分、GOS預(yù)后評(píng)分、腦積水、低Na血癥及腦梗死發(fā)生率、術(shù)中動(dòng)脈瘤破裂患者預(yù)后情況為評(píng)定效果及安全性指標(biāo)進(jìn)行回顧性分析并對(duì)其結(jié)果進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:手術(shù)組動(dòng)脈瘤完全夾閉率與介入組完全填塞率無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。Hunt-HessⅠ及Ⅱ級(jí)患者定向力、記憶力或計(jì)算力、回憶力、注意力及語(yǔ)言功能介入組均優(yōu)于手術(shù)組(P0.05);Hunt-HessⅢ-Ⅳ級(jí)患者定向力、記憶力或計(jì)算力、回憶力、注意力及語(yǔ)言功能手術(shù)組均優(yōu)于介入組(P0.05)。手術(shù)組與介入組中Hunt-Hess Ⅰ及Ⅱ級(jí)患者腦室擴(kuò)張或腦積水、低Na血癥及腦梗死發(fā)生率均無(wú)明顯差別(P0.05),Hunt-HessⅢ-Ⅳ級(jí)患者腦室擴(kuò)張或腦積水及低Na血癥及腦梗死發(fā)生率手術(shù)組均低于介入組(P0.05)。對(duì)于動(dòng)脈瘤術(shù)中破裂患者的預(yù)后,手術(shù)組明顯優(yōu)于介入組(P0.05)。Hunt-HessⅢ-Ⅳ級(jí)患者GOS預(yù)后評(píng)分良好率手術(shù)組優(yōu)于介入組(P0.05)。結(jié)論1.就處理前交通動(dòng)脈瘤的成功率而言,手術(shù)夾閉術(shù)與介入栓塞術(shù)均是治療前交通動(dòng)脈瘤的有效手段。2.開顱手術(shù)夾閉術(shù)在應(yīng)對(duì)和控制術(shù)中前交通脈動(dòng)脈瘤的破裂方面較介入栓塞術(shù)更具優(yōu)勢(shì)。3.對(duì)于Hunt-HessⅢ-Ⅳ的患者,前交通動(dòng)脈瘤手術(shù)夾閉術(shù)可降低術(shù)后并發(fā)癥的發(fā)生率,故如患者能耐受手術(shù),優(yōu)先考慮行開顱夾閉術(shù)。4.對(duì)于Hunt-HessⅠ-Ⅱ的前交通動(dòng)脈瘤患者介入栓塞術(shù)在保護(hù)患者認(rèn)知功能方面優(yōu)于手術(shù)夾閉術(shù)。
[Abstract]:Objective: to investigate the clinical effect of surgical clipping and interventional embolization in the treatment of anterior communicating aneurysm. From January 2015 to January 2017, 95 patients with anterior communicating aneurysm treated in our hospital were randomly selected according to the inclusion criteria. The clinical data were collected and divided into operation group and interventional group according to the treatment methods. The MMSE mini-mental state examination scale was used to evaluate the prognosis and hydrocephalus of the above patients 2 weeks after operation. The incidence of hyponatremia and cerebral infarction. The prognosis of patients with ruptured aneurysm during operation was analyzed retrospectively and the results were statistically analyzed. There was no significant difference between the complete occlusion rate of aneurysms in the operation group and the complete tamponade rate in the interventional group (. P0.05, Hunt-Hess grade 鈪，

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