赵晖

[摘要] 目的 為了提高颅内动脉瘤的治疗效果，比较血管内介入疗法和显微神经外科手术两种治疗方案在临床疗效和安全性等方面的差异。 方法 依据随机、双盲、对照原则的相关要求，在该院2017年3月—2018年3月接诊的颅内动脉瘤患者中随机选取78例作为研究对象并将其平均分为两组，其中予以血管介入疗法治疗的39例患者列为观察组，予以显微神经外科手术方案治疗的39例患者列为对照组，比较两种治疗方案在临床疗效、手术指标以及并发症等方面的差异。 结果 研究数据显示，对照组和观察组患者术后恢复良好率分别为32（82.05%）和23（58.97%），和观察组相比对照组患者术后恢复良好率明显增加且组间比较差异有统计学意义（χ2=6.910，P<0.05）;观察组患者的术中失血量、术中用时以及住院时间分别为（88.19±4.25）mL、（85.22±7.23）min、（13.33±2.26）d，而对照组则分别为（153.55±8.56）mL、（150.41±8.71）min、（20.55±3.80）d，与对照组相比，观察组患者的术中失血量明显减少而术中用时以及住院时间则明显缩短（P<0.05）;对照组和观察组患者术后并发症的发生率分别为10（25.64%）和2（5.13%），和观察组相比对照组患者术后并发症发生率明显增加且组间比较差异有统计学意义（χ2=6.300，P<0.05）。 结论 血管内介入疗法和显微神经外科手术两种方案治疗颅内动脉瘤各有利弊，其中纤维神经外科手术治疗效果更好，而血管介入疗法术中用时和创伤更少，并发症发生率更低，安全性更高，临床应根据患者病情合理选择手术方式。

[关键词] 血管内介入疗法;显微神经外科手术;颅内动脉瘤;临床疗效;安全性

[中图分类号] R651.1          [文献标识码] A          [文章编号] 1674-0742（2019）11（a）-0041-03

Comparison of Clinical Efficacy and Safety between Endovascular Interventional Therapy and Microsurgical Neurosurgery for Intracranial Aneurysms

ZHAO Hui

Department of Neurosurgery， Zibo Central Hospital， Zibo， Shandong Province， 255020 China

[Abstract] Objective To improve the therapeutic effect of intracranial aneurysms and compare the clinical efficacy and safety of intravascular interventional therapy and microsurgical neurosurgery. Methods According to the requirements of randomized， double-blind， and contrasted principles， 78 patients with intracranial aneurysms who were admitted to our hospital from March 2017 to March 2018 were randomly selected as subjects and divided into two groups. 39 patients treated with vascular interventional therapy were included in the observation group. 39 patients who underwent microsurgical neurosurgery were included in the control group. The differences in clinical efficacy， surgical parameters， and complications between the two treatment regimens were compared. Results The data of the study showed that the recovery rate of the control group and the observation group were 32 （82.05%） and 23 （58.97%）， respectively. Compared with the observation group， the recovery rate of the control group was significantly increased and the difference between the groups was compared. It was statistically significant （χ2=6.910， P<0.05）. The intraoperative blood loss， intraoperative time and hospitalization time of the observation group were （88.19±4.25）mL， （85.22±7.23） min， （13.33±2.26） d， respectively， while the control group was （153.55±8.56）mL， （150.41±8.71） min， （20.55±3.80） d， compared with the control group， the observed group of patients with reduced blood loss during surgery and intraoperative time and the length of hospital stay was significantly shorter （P<0.05）; the incidence of postoperative complications in the control group and the observation group were 10 （25.64%） and 2 （5.13%）， respectively， compared with the observation group. The incidence increased significantly and the difference between the groups was statistically significant （χ2=6.300， P<0.05）. Conclusion Endovascular intervention and microsurgical neurosurgery have advantages and disadvantages in the treatment of intracranial aneurysms. Among them， fiber neurosurgery has better therapeutic effect， while vascular interventional therapy has less time and trauma， and the complication rate is lower， safer， clinically should choose the surgical method according to the patient's condition.

[Key words] Endovascular interventional therapy; Microsurgical neurosurgery; Intracranial aneurysm; Clinical efficacy; Safety

颅内动脉瘤是临床上诱发自发性蛛网膜下腔出血的最常见原因，是因颅内局部血管出现异常改变并导致动脉管壁上发生异常突起，以40～60岁的中年人好发，现阶段对颅内动脉瘤的发病机制仍处于进一步的探索中[1]。近年来伴随微创技术的发展和进步，颅内动脉瘤的治疗效果也有了明显的提高，当下以血管内介入疗法和显微神经外科手术两种治疗方案在临床上应用最多[2]。该院依据随机、双盲、对照原则的相关要求从2017年3月—2018年3月接诊的颅内动脉瘤患者中随机选取78例作为研究对象并在分组后给予血管介入疗法和显微神经外科手术两种方案治疗，取得了一定的研究成果，现报道如下。……