本文選題：寬頸動(dòng)脈瘤 + 支架輔助�。� 參考：《廣西醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：探討寬頸動(dòng)脈瘤破裂出血超早期診療方法、安全性及預(yù)后。 方法：回顧性分析我科2010年1月到2013年12月之間，使用支架輔助栓塞或開顱夾閉治療超早期（48h）顱內(nèi)寬頸動(dòng)脈瘤破裂出血50例，動(dòng)脈瘤55個(gè)，比較觀測(cè)兩組手術(shù)相關(guān)并發(fā)癥、復(fù)發(fā)率及預(yù)后。動(dòng)脈瘤栓塞程度采用Raymond分級(jí)，預(yù)后采取改良mRS評(píng)分，0～2分為良好，，3～6分為不良。 結(jié)果：用支架輔助栓塞組28例患者共31個(gè)動(dòng)脈瘤，術(shù)后良好率(82.1%)，開顱夾閉組22例患者共24個(gè)動(dòng)脈瘤，術(shù)后良好率(81.8%)。兩組在治療效果及預(yù)后上無統(tǒng)計(jì)學(xué)意義。開顱夾閉組在術(shù)后閉塞率上優(yōu)于支架輔助栓塞（P0.05），開顱夾閉組在手術(shù)相關(guān)并發(fā)癥較支架輔助栓塞發(fā)生率高，但兩組差別無統(tǒng)計(jì)學(xué)意義（P0.05）。支架輔助栓塞復(fù)發(fā)率較開顱夾閉組高，但兩組差別無統(tǒng)計(jì)學(xué)意義；開顱夾閉組平均住院日較支架輔助栓塞組長(zhǎng)，兩組有統(tǒng)計(jì)學(xué)意義（P0.05）。 結(jié)論：手術(shù)開顱夾閉和支架輔助栓塞均為治療顱內(nèi)寬頸動(dòng)脈瘤的有效方法。手術(shù)夾閉寬頸動(dòng)脈瘤致密栓塞率優(yōu)于支架輔助栓塞；支架輔助栓塞組寬頸動(dòng)脈瘤復(fù)發(fā)率較手術(shù)夾閉組高，但兩組差別無統(tǒng)計(jì)學(xué)意義；支架輔助栓塞組相對(duì)于手術(shù)夾閉組手術(shù)相關(guān)并發(fā)癥發(fā)生率低，創(chuàng)傷小、恢復(fù)快。
[Abstract]:Objective: to explore the method, safety and prognosis of super-early diagnosis and treatment for ruptured hemorrhage of wide-necked aneurysms. Methods: from January 2010 to December 2013, 50 patients (55 aneurysms) with ruptured intracranial wide-necked aneurysms were treated with stent-assisted embolization or craniotomy for 48 h. The complications associated with operation were compared between the two groups. Recurrence rate and prognosis. The degree of embolism of aneurysm was classified by Raymond grade, and the prognosis was improved by mRS score. Results: there were 31 aneurysms in 28 patients in the stent-assisted embolization group, the good rate was 82.1%, and 24 aneurysms in 22 patients in the craniotomy clipping group. The good rate was 81.8%. There was no significant difference in therapeutic effect and prognosis between the two groups. The rate of occlusion in the open clipping group was better than that in the stent assisted embolization group (P 0.05). The incidence of operative complications in the craniotomy clipping group was higher than that in the stent assisted embolization group, but the difference between the two groups was not statistically significant (P 0.05). The recurrence rate of stent assisted embolization was higher than that of open clipping group, but there was no significant difference between the two groups. Conclusion: surgical clipping and stent-assisted embolization are effective methods for the treatment of intracranial wide-necked aneurysms. The recurrence rate of wide carotid aneurysm in the stent assisted embolization group was higher than that in the operation clipping group, but there was no significant difference between the two groups. Compared with the clipping group, the stent-assisted embolization group had lower incidence of operative complications, less trauma and faster recovery.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R739.41

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