Ba Yongfeng, Zhang Chaoyong, Huang Jinbang, Hua Xiangting, Cui Tao, Zhao Shiwei, Gao Ge
Department of Neurosurgery, Taihe County People's Hospital Fuyang, Anhui Province, China.
Department of Neurosurgery, The First Affiliated Hospital of USTC, Anhui Provincial Hospital Hefei, Anhui Province, China.
Am J Transl Res. 2021 Jul 15;13(7):8040-8048. eCollection 2021.
We aimed to compare the efficacy of microsurgical clipping of intracranial aneurysms with that of arterial embolization in the treatment of ruptured anterior circulation aneurysms.
The clinical data of 68 patients treated in our hospital for ruptured anterior circulation aneurysms between January 2017 and March 2020 were analyzed retrospectively. According to the surgical methods, the patients were divided into two groups: the microsurgical clipping group (30 cases) and the arterial embolization group (38 cases). The following markers were compared between the two groups: Hunt-Hess classification (HHC) grading, aneurysm occlusion rate, and incidence of postoperative complications, length of hospital stay, hospitalization cost, and the scores of the Glasgow Outcome Scale, Modified Rankin Scale, and Barthel Index during the 6-months follow-up after hospital discharge.
The cases of HHC grade I and II increased in both groups at hospital discharge (both P<0.05), and there was no intergroup difference in this marker (P>0.05). The complete occlusion rate in the microsurgical clipping group was higher than that in the arterial embolization group (P<0.05). Compared with the microsurgical clipping group, the arterial embolization group had shorter length of hospital stay and higher hospitalization cost (both P<0.05). There was no difference in the total incidence of postoperative complications between the two groups (P>0.05). However, the arterial embolization group had lower incidence of intracranial infection and higher incidence of vasospasm than the microsurgical clipping group (both P<0.05). During the follow-up, the arterial embolization group had better results in terms of the Modified Rankin Scale and Barthel Index results and had more patients with GOS score of 5 points than the microsurgical clipping group (all P<0.05).
Both microsurgical clipping of intracranial aneurysms and arterial embolization can effectively treat ruptured anterior circulation aneurysms, and the short-term efficacy achieved by these two methods is similar. Compared with microsurgical clipping of intracranial aneurysms, arterial embolization can lead to shorter hospitalization, lower incidence of intracranial infection, and better patients' prognosis and quality of life after the operation. However, the microsurgical clipping of intracranial aneurysms can achieve higher complete occlusion rate, lower incidence of vasospasm, and lower hospitalization cost than arterial embolization.
我们旨在比较颅内动脉瘤显微夹闭术与动脉栓塞术治疗破裂前循环动脉瘤的疗效。
回顾性分析2017年1月至2020年3月在我院接受治疗的68例破裂前循环动脉瘤患者的临床资料。根据手术方法，将患者分为两组：显微夹闭组（30例）和动脉栓塞组（38例）。比较两组患者的以下指标：Hunt-Hess分级（HHC）、动脉瘤闭塞率、术后并发症发生率、住院时间、住院费用以及出院后6个月随访时的格拉斯哥预后量表、改良Rankin量表和Barthel指数评分。
两组患者出院时HHC I级和II级病例数均增加（均P<0.05），该指标组间无差异（P>0.05）。显微夹闭组的完全闭塞率高于动脉栓塞组（P<0.05）。与显微夹闭组相比，动脉栓塞组住院时间较短，住院费用较高（均P<0.05）。两组术后并发症总发生率无差异（P>0.05）。然而，动脉栓塞组颅内感染发生率低于显微夹闭组，血管痉挛发生率高于显微夹闭组（均P<0.05）。随访期间，动脉栓塞组在改良Rankin量表和Barthel指数结果方面表现更好，格拉斯哥预后量表评分为5分的患者比显微夹闭组更多（均P<0.05）。
颅内动脉瘤显微夹闭术和动脉栓塞术均可有效治疗破裂前循环动脉瘤，两种方法的短期疗效相似。与颅内动脉瘤显微夹闭术相比，动脉栓塞术可缩短住院时间，降低颅内感染发生率，术后患者预后及生活质量更好。然而，颅内动脉瘤显微夹闭术比动脉栓塞术可实现更高的完全闭塞率、更低的血管痉挛发生率和更低的住院费用。
