Anterior circulation aneurysms

  • 文章类型: Meta-Analysis
    比较前循环动脉瘤破裂患者夹闭和卷绕的安全性和疗效。对四个数据库的系统搜索(PubMed,WebofScience,科克伦图书馆,和Embase)进行了研究,以确定前循环动脉瘤破裂患者的血管内线圈和手术夹闭的比较文章。采用随机效应模型进行Meta分析。十九项研究,包括1983名患者,包括在内。荟萃分析显示,神经外科夹闭与较低的再治疗发生率相关(OR:0.28,95%CI(0.11,0.70),P=0.006)比血管内卷绕,这似乎是不完全闭塞的结果(OR:0.22,95%CI(0.11,0.45),P<0.001)。神经外科手术夹闭与较低的死亡率相关(OR:0.45,95%CI(0.25,0.82),短期随访时P=0.009)比血管内线圈。然而,神经外科夹闭显示缺血性梗死发生率较高(OR:2.28,95%CI(1.44,3.63),P<0.001)和更长的住院时间(LOS)(WMD:6.12,95%CI(4.19,8.04),P<0.001)术后比腔内盘绕。此外,汇总结果显示,两组之间在不良结局方面没有统计学上的显着差异,长期死亡率,再出血,血管痉挛,和脑积水.来自此系统评价的证据表明,对于破裂的前循环动脉瘤,神经外科手术夹闭可能优于血管内卷绕。应进行大规模RCT以验证这些结果,并根据患者状况提供结果。
    To compare the safety and efficacy of clipping and coiling in patients with ruptured anterior circulation aneurysms. A systematic search of four databases (PubMed, Web of Science, Cochrane Library, and Embase) was conducted to identify comparative articles on endovascular coiling and surgical clipping in patients with ruptured anterior circulation aneurysms. Meta-analyses were conducted using random-effects models. Nineteen studies, including 1983 patients, were included. The meta-analysis showed that neurosurgical clipping was associated with a lower incidence of retreatment (OR:0.28, 95% CI (0.11, 0.70), P = 0.006) than endovascular coiling, which seemed to be a result of incomplete occlusion (OR:0.22, 95% CI (0.11, 0.45), P < 0.001). Neurosurgical clipping was associated with lower mortality (OR:0.45, 95% CI (0.25, 0.82), P = 0.009) at short-term follow-up than endovascular coiling. However, neurosurgical clipping showed a higher incidence of ischemic infarction (OR:2.28, 95% CI (1.44, 3.63), P < 0.001) and a longer length of stay (LOS) (WMD:6.12, 95% CI (4.19, 8.04), P < 0.001) after surgery than endovascular coiling. Furthermore, the pooled results showed no statistically significant differences between the two groups regarding poor outcome, long-term mortality, rebleeding, vasospasm, and hydrocephalus. Evidence from this systematic review illustrates that neurosurgical clipping may be superior to endovascular coiling for ruptured anterior circulation aneurysms. Large-scale RCTs should be conducted to verify these outcomes and provide results according to patient status.
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  • 文章类型: Journal Article
    探讨介入栓塞治疗前循环动脉瘤的临床疗效及安全性。
    对2019年6月至2021年12月乐山市人民医院收治的80例前循环动脉瘤患者进行回顾性分析。根据手术方式的不同,分为观察组和对照组。观察组患者给予介入栓塞治疗,对照组给予开颅夹闭。手术疗效,术后神经功能和生活质量,比较两组患者的手术预后及手术并发症。
    观察组术中出血量、住院时间均低于对照组(p<0.05)。观察组术后3个月的Hunt-Hess评分和改良Rankin量表评分均显著低于对照组(p<0.05)。观察组预后良好率高于对照组(p<0.05)。此外,观察组并发症发生率为12.50%,显著低于对照组的32.50%(p<0.05)。
    介入栓塞术显示了微创手术的优势,例如更短的手术时间和更短的住院时间。能显著改善患者的神经功能和生活质量,具有较好的临床安全性,改善患者的预后,减少并发症的发生。
    UNASSIGNED: To investigate the clinical efficacy and safety of interventional embolization in the treatment of anterior circulation aneurysms.
    UNASSIGNED: Eighty patients with anterior circulation aneurysms admitted to People\'s Hospital of Leshan from June 2019 to December 2021 were retrospectively analyzed. According to the different surgical methods, they were divided into two groups: the observation group and the control group. Patients in the observation group were given interventional embolization, while those in the control group were given craniotomy clipping. The surgical efficacy, postoperative neurological function and quality of life, surgical prognosis and surgical complications of the two groups were compared.
    UNASSIGNED: The intraoperative blood loss and hospitalization time in the observation group were lower than those in the control group (p<0.05). The scores of the Hunt-Hess and modified Rankin scale in the observation group were significantly lower than those in the control group three months after surgery (p<0.05). The good prognosis rate of the observation group was higher than that of the control group (p<0.05). Moreover, the complication rate of the observation group was 12.50%, which was significantly lower than 32.50% in the control group (p<0.05).
    UNASSIGNED: Interventional embolization shows the advantages of minimally invasive procedures such as shorter operative times and shorter hospital stays. It has better clinical safety because it can significantly improve the neurological function and quality of life of patients, improve the prognosis of patients, and reduce the incidence of complications.
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