本文選題：腦動脈瘤 + 開顱夾閉術(shù)　； 參考：《延邊大學(xué)》2014年碩士論文

【摘要】：目的：目前對于腦動脈瘤破裂有兩種規(guī)范的治療手段,分別為血管內(nèi)介入栓塞術(shù)與開顱手術(shù)夾閉動脈瘤。本論文目的在于對上述兩種治療方法進(jìn)行對比研究,分析采用兩種治療方法的異同點(diǎn),如住院時間,手術(shù)時間,手術(shù)類型,住院費(fèi)用,相關(guān)并發(fā)癥等方面的差異及原因,為臨床治療提供參考。 方法：經(jīng)判定兩種治療方式均無禁忌證、均為適應(yīng)癥的患者,分成兩組：開顱手術(shù)治療組(A組)和血管內(nèi)介入栓塞組(B組),記錄患者入院時的病情,Hunt分級、出血次數(shù)、動脈瘤(出血)部位,記錄患者的治療情況與病情發(fā)展結(jié)果。隨訪觀察1年,,記錄患者手術(shù)時間,住院時間,手術(shù)部位患者恢復(fù)情況及并發(fā)癥情況等,并采用Glasgow結(jié)果評分評價。 結(jié)果：開顱夾閉術(shù)組(A組)手術(shù)操作時間為2.97±0.601.9～4.2)小時,血管內(nèi)介入栓塞術(shù)組(B組)手術(shù)操作時間為2.13±0.61(1.1～3.5)小時,P0.01。開顱夾閉術(shù)組(A組)住院天數(shù)為1.2±2.6(12～22)天,血管內(nèi)介入組(B組)住院天數(shù)為10.6±2.1(7～15)天,兩組比較采用t檢驗(yàn),P0.01。通過數(shù)據(jù)我們可見動脈瘤介入栓塞治療手術(shù)時間短,減少住院周期,均優(yōu)于開顱手術(shù)組。開顱手術(shù)夾閉治療組：平均年齡為52.8±9.3歲；血管內(nèi)介入栓塞組：平均年齡為63.5±11.9歲,P0.01。在前交通動脈瘤、椎基底動脈瘤手術(shù)中介入組應(yīng)用較開顱組多,均P0.01,后交通動脈瘤開顱手術(shù)組應(yīng)用較多,P0.01。腦動脈瘤介入栓塞術(shù)治療比較開顱夾閉組住院時間短,減少住院周期,介入組術(shù)后隨訪遠(yuǎn)期治療效果好。以介入組平均年齡較開顱組高,并且介入組僅僅在后交通動脈瘤應(yīng)用較少,在椎基底動脈腦動脈瘤手術(shù)開顱夾閉術(shù)做不了的手術(shù)主要以介入栓塞術(shù)為主要治療手段,我們認(rèn)為介入組適用性更廣。。 結(jié)論： 1.血管內(nèi)介入栓塞術(shù)適用范圍廣。 2.腦動脈瘤手術(shù)首選血管內(nèi)介入栓塞術(shù)。 3腦動脈瘤血管內(nèi)栓塞術(shù)遠(yuǎn)期治療效果優(yōu)于開顱夾閉術(shù)。
[Abstract]:Objective: at present, there are two kinds of standard treatment for ruptured cerebral aneurysms, one is endovascular embolization and the other is clipping the aneurysm after craniotomy. The purpose of this paper is to compare the two treatment methods, and analyze the differences and reasons of the two methods, such as hospitalization time, operation time, operation type, hospitalization cost, related complications and so on. To provide a reference for clinical treatment. Methods: the patients with no contraindication and indications were divided into two groups: craniotomy group (group A) and endovascular embolization group (group B). The patients were divided into two groups: group A (group A) and group B (group B). Aneurysm (bleeding) site, record the patient's treatment and the development of the disease. All patients were followed up for 1 year to record the time of operation, the time of hospitalization, the condition of recovery and complications of the patients at the site of operation, and to evaluate the results of Glasgow. Results: the operative time of group A was 2.97 鹵0.601.9 鹵4.2 hours, and that of group B was 2.13 鹵0.61 鹵1.11 鹵3.5) hours (P 0.01). The days of hospitalization in group A and group B were 1.2 鹵2.6 and 10.6 鹵2.1 ~ 7 ~ 15) days respectively. T test was used to compare the two groups (P < 0.01). According to the data we can see that the interventional embolization of aneurysms is better than the craniotomy group because of the shorter operation time and less hospitalization period. The mean age was 52.8 鹵9.3 years in clipping group and 63.5 鹵11.9 years old in endovascular embolization group (P 0.01). In the anterior communicating artery aneurysm, the interventional group was more than the craniotomy group in the operation of vertebrobasilar aneurysm (P0.01), and the posterior communicating aneurysm was more used in the craniotomy group (P0.01). The interventional embolization of cerebral aneurysm was more effective than that of the clipping group. The average age of the interventional group was higher than that of the craniotomy group, and the interventional group was only used less in the posterior communicating artery aneurysm. We think the intervention group is more applicable. Conclusion: 1. Endovascular embolization is widely used. 2. Endovascular embolization is the first choice in the operation of cerebral aneurysm. 3 the long-term therapeutic effect of endovascular embolization for cerebral aneurysms was better than that of open-craniotomy.
【學(xué)位授予單位】：延邊大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R739.41

【參考文獻(xiàn)】

相關(guān)期刊論文 前9條

1 劉思宏;;腦動脈瘤病人術(shù)前肺功能對術(shù)后肺部感染的影響[J];長春中醫(yī)藥大學(xué)學(xué)報;2011年05期

2 張政;韓劍虹;李迎春;曹毅;朱劍萍;;256層螺旋CT三維血管成像與三維DSA診斷顱內(nèi)動脈瘤的對比分析[J];中國腦血管病雜志;2012年01期

3 齊猛;史繼新;;蛛網(wǎng)膜下腔出血患者貧血的研究進(jìn)展[J];中國腦血管病雜志;2012年01期

4 陳高,張建民,李珉,蔡菁;動脈瘤性SAH繼發(fā)重度腦血管痙攣相關(guān)因素研究[J];中華神經(jīng)外科雜志;2005年11期

5 張世明;;腦動脈瘤夾閉術(shù)中的監(jiān)測問題[J];中華神經(jīng)外科雜志;2007年11期

6 郭付有,游潮,孫鴻,蔡博文,徐建國;腦動脈瘤破裂的早期手術(shù)治療探討[J];中國急救醫(yī)學(xué);2003年05期

7 劉翼;游潮;賀民;惠旭輝;周良學(xué);王翔;曾義;;顱內(nèi)破裂動脈瘤手術(shù)時機(jī)的探討(附237例分析)[J];中國微侵襲神經(jīng)外科雜志;2007年05期

8 左長京,王培軍,田建明,許奕,劉建民,蕭毅,崔恒武,王敏杰;螺旋CT血管造影對腦動脈瘤栓塞治療的指導(dǎo)價值[J];中國醫(yī)學(xué)影像技術(shù);2001年03期

9 盧靖;詹偉雄;劉天慶;沈東煒;;SolitaireAB型支架輔助彈簧圈栓塞顱內(nèi)復(fù)雜動脈瘤的初步經(jīng)驗(yàn)(19例報道)[J];中國神經(jīng)精神疾病雜志;2012年11期

，

本文編號：1810340