| Objective:Intracranial aneurysm dissection difficult diagnosis and treatment,the prognosis is poor.This study was designed to dissection of intracranial aneurysms treated with endovascular treatment within individual way,and intracranial vascular bypass the traditional combination of microsurgical treatment of intracranial aneurysm dissection methods and efficacy were compared to lower cranial artery dissection mortality,morbidity,improve the quality of life of patients for the purpose of providing a method for clinical application value.Methods:The object of study for December 2008 to October 2012 in multicenter clinical comparative study of 40 patients with dissecting aneurysm.Selection criteria:the imaging diagnosis of intracranial artery dissection aneurysm patients,group therapy,the team line of digital subtraction angiography(DSA)inspection,clear according to the results to choose the right method after the lesion site of aneurysm endovascular treatment;The control line of digital subtraction angiography(DSA)inspection,pathological changes of clear choose microsurgical brain after bypass surgery.The team after 3 months,6 months to Glasgow(GOS)score graded as an index for curative effect analysis;According to the preoperative general situation(age,gender,the location of the aneurysm Hunt-Hess classification and grade of CT Fisher)two pairs,eliminate cannot pair of patients,after screening,of the line and endovascular treatment of 20 cases of patients with cerebrovascular bypass patients with worth 20 cases were analyzed.Compared to hospital for 3 months,6 months after the GOS score,the incidence of postoperative complications and preoperative waiting time,by paired sample T test and chi-square test were analyzed,and to clarify what kind of treatment curative effect indeed.Results:1 after 3 months of Glasgow Outcome Scale comparison.4 cases of patients with cerebral vascular bypass group after bad,column 2 of them died,after the defective rate is 20.00%;Endovascular treatment group 2 cases of poor prognosis,including 1 case death,after the defective rate 10.00%.Paired sample T test,calculated by SPSS:T=2.666,P<0.05,the difference was statistically significant.2 after 6 months of Glasgow Outcome Scale comparison.3 cases of patients with cerebral vascular bypass group after bad,column 2 of them died,after the defective rate is 15.00%;Endovascular interventional treatment group 2 patients with poor prognosis,and 1 case died,after the defective rate 10.00%.Paired sample T test,calculated by SPSS:T=2.990,P<0.05,the difference was statistically significant.3 the postoperative complicationsCerebral vascular bypass line 3 patients in group two bypass surgery,2 cases of postoperative infection,1 case because of the complicated with pneumonia,1 case of hydrocephalus in bed for a long time,endovascular treatment group 1 case complicated with hydrocephalus and 1 case was bleeding again,the incidence of complications of endovascular treatment group was obviously lower vascular bypass group(P<0.05),the difference was statistically significant.4 preoperative waiting timeEndovascular treatment group preoperative waiting time for d(0.6 and 0.7),cerebral vascular bypass group preoperative wait time(13.9 and 2.9)d,endovascular treatment of preoperative waiting time significantly less than the cerebral vascular bypass groups,statistically significant difference(P<0.01).Conclusions:In the medical records were retrospectively analyzed from GOS score,postoperative complications and prognosis of preoperative waiting time perspective,endovascular treatment group is superior to cerebral vascular bypass group,difference was statistically significant,can be thought of in the treatment of intracranial artery dissection aneurysm,endovascular treatment,and vascular bypass method are optional,but the endovascular treatment on prognosis GOS score,postoperative complications,and preoperative bypass treatment is better than waiting time three aspects of blood vessels. |
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