摘要
目的:比较不同手术时机治疗颅内前循环动脉瘤破裂患者的疗效及对患者远期预后的影响。方法:回顾性分析我院2010年3月~2015年10月收治的120例颅内前循环动脉瘤破裂患者的临床资料,所有患者均接受显微手术夹闭治疗,按手术时机分为超早期组(<24 h,n=43)、早期组(24-72 h,n=36)、延期组(≥10 d,n=41),比较各组术后颅内动脉栓塞改善程度,统计各组术中及术后并发症发生情况,采用格拉斯哥量表(GOC)评定患者术后恢复情况,采用改良Rankin(m RS)表评定患者远期预后。结果:超早期组完全栓塞率略高于早期组、延期组,但对比差异无统计学意义(P>0.05);超早期组术中、术后各并发症发生率略低于早期组、延期组,但对比差异无统计学意义(P>0.05);术后6、12、24个月,超早期组、延期组GOS评分高于早期组、m RS评分低于早期组,超早期组GOS评分高于延期组,m RS评分低于延期组(P<0.05)。结论:不同手术时机治疗颅内前循环动脉瘤破裂手术效果无明显差异,但超早期、延期手术患者术后恢复及预后评分稍优于早期手术。
Objective： To compare the effect of different surgical timing in the treatment of patients with ruptured intracranial anterior circulation aneurysms and its effect on the long-term prognosis of patients. Methods： The clinical data of 120 patients with ruptured intracranial anterior circulation aneurysms who were admitted in our hospital between March 2010 and October 2015were analyzed retrospectively. All patients were treated with microsurgical clipping. According to surgical timing, they were divided into ultra-early group （〈24 h, n=43）, early group （24-72 h, n=36） and delayed group （d = 10, n=41）. The improvement of intracranial arterial embolization was compared between groups. The incidence rates of postoperative complications in all groups were statistically analyzed. Postoperative recovery of patients was evaluated by the Glasgow scale （GOC）, and the long-term prognosis of patients was evaluated by modified Rankin scale （mRS）. Results： The rate of complete embolism in the ultra-early group was slightly higher than that in the early group and delayed group （P〉0.05）; The incidence rates of intraoperative and postoperative complications in ultra-early group were slightly lower than those in early group and delayed group （P〉0.05）; At 6, 12 and 24 months after surgery, GOS scores of the ultra-early group and delayed group were higher than those of the early group while mRS scores were lower than those of the early group. GOS scores of ultra-early group were higher than those of the delayed group while mRS scores were lower than those of the delayed group （P〈0.05）. Conclusion： There are no significant differences in surgical effects of different timing of surgery in the treatment of intracranial anterior circulation aneurysm rupture. However, the postoperative recovery and prognosis scores of patients undergoing ultra-early and delayed surgery are slightly better than early surgery.
出处
《现代生物医学进展》
CAS
2017年第8期1566-1569,1587,共5页
Progress in Modern Biomedicine
基金
湖北医药学院附属人民医院2014年院级科研项目计划(2014zd06)
关键词
前循环动脉瘤
手术
超早期
预后
Anterior circulation aneurysm
Surgery
Ultra-early
Prognosis
