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目的:探讨开颅夹闭和血管内栓塞治疗颅内动脉瘤的效果比较及并发症。方法:从2003~2008年近五年来我院收治的颅内动脉瘤54例,其中开颅夹闭24例(Hunt-Hess分级Ⅰ~Ⅱ级20例,Ⅲ级2例,Ⅳ级2例),共26个动脉瘤。血管内栓塞30例(Hunt-Hess分级Ⅰ~Ⅱ级23例,Ⅲ级5例,Ⅳ级2例),共31个动脉瘤。临床结果按GOS进行评价。结果:两组的良好率、并发症及死亡率无显著差别(P>0.05)。随访平均12月,Ⅰ~Ⅱ级动脉瘤患者治疗良好率为100.0%(43/43),并发症发生率为4.7%(2/43),Ⅲ~Ⅳ级者分别为18.2%(2/11)和90.9%(10/11),两者相差显著(P<0.05)。结论:开颅夹闭和血管内栓塞治疗颅内动脉瘤,二者疗效相仿,各有优缺点。动脉瘤患者病情级别越高,治疗效果越差。
Objective: To investigate the effects of craniotomy and endovascular embolization on intracranial aneurysms and their complications. Methods: Fifty-four patients with intracranial aneurysm admitted to our hospital in recent five years from 2003 to 2008 were enrolled, including 24 cases of craniotomy occlusion (Hunt-Hess grade Ⅰ ~ Ⅱ 20 cases, Ⅲ grade 2 cases and Ⅳ grade 2 cases) A total of 26 aneurysms. Thirty patients underwent endovascular embolization (Hunt-Hess grade Ⅰ ~ Ⅱ 23, grade Ⅲ 5, grade Ⅳ 2), a total of 31 aneurysms. The clinical results were evaluated by GOS. Results: There was no significant difference between the two groups in the rate of goodness, complication and mortality (P> 0.05). The average follow-up was 12 months. The good rate of treatment was 100.0% (43/43) in patients with grade Ⅰ ~ Ⅱ aneurysm, the complication rate was 4.7% (2/43), and those in grade Ⅲ ~ Ⅳ were 18.2% (2/11 ) And 90.9% (10/11), respectively, with a significant difference (P <0.05). Conclusion: Craniotomy and endovascular embolization for the treatment of intracranial aneurysms have similar curative effects and their advantages and disadvantages. The higher the severity of aneurysm patients, the worse the treatment.