Comparison And Analysis Of Curative Effect Between Craniotomy Clipping And Interventional Embolization Treatment In Ruptured Anterior Communicating Artery Aneurysm

Objective:By analyizing the effect of the craniotomy clipping and interventional embolization treatment of ruptured anterior communicating artery aneurysm,comparing the advantages and disadvantages between them in order to get the clinic guidance.Methods:A retrospective analysis was carried out complete clinic data on 73cases of patients with ruptured anterior communicating artery aneurysm who were treated in Neurosurgery of the Affiliated Hospital of Cheng De Medical University with single craniotomy clipping or interventional embolization from September 2015 to December 2017.According to the surgical method divided into two groups:31 cases of craniotomy clipping group,42 cases of interventional embolization group;According to the operation time divided into early operation(?3days)and late operation(>3days).Recording the clinic information as followed:name?gender?age?the medical record number?imaging data?preoperative Hunt-Hess grade?operation date?postoperative complications?the time of hospitalization?hospitalization expenses?discharging GOS score and MRS score of postoperative follow-up of 3 months and others to analyse statistical data.Results:1.Interventional embolization group:42 people,37cases had good discharge recovery(GOS 4-5)and 5 cases were bad discharge recovery(GOS1-3).The craniotomy clipping group:31 people,24 cases had good discharge recovery(GOS 4-5)and 7 cases were bad discharge recovery(GOS 1-3).The results showed that there were no statistical difference among the discharge recovery extent of the two groups(X~2test,P>0.05).2.The craniotomy clipping group and interventional embolization group of patients'time of hospitalization and hospitalization expenses with significance statistical difference(t test,P<0.05).3.With no statistical difference in the postoperative complications of the two groups((Fisher'S exact test,P>0.05).4.With no statistical difference in the prognosis extent of follow-up 3months after discharge from hospital between two groups(X~2test,P>0.05).5.With no statistical difference in the craniotomy clipping group on the discharge recovery extent of early operation and late operation(Fisher'S exact test,P>0.05).However on prognosis extent of followed-up 3 months after discharge from hospital there were significant statistical difference(Fisher'S exact test,P>0.05);With no statistical difference (Fisher'S exact test,P>0.05)in interventional emmbolization group on the discharge recovery extent of early operation and late operation in time for prognosis extent of follow-up 3 months after discharge from hospital.6.With no statistical difference(Fisher'S exact test,P>0.05)in the early operation between two groups on the discharge recovery extent and prognosis extent of follow-up 3 months after discharge from hospital;With no statistical difference(Fisher'S exact test,P>0.05)in the late operation between two groups on the discharge recovery extent and prognosis extent of follow-up 3 months after discharge from hospital.Conclusion:1.To treat ruptured anterior communicating artery aneurysms is significant effective both the craniotomy clipping and interventional embolization.2.The early operation of patients with craniotomy clipping was better than that of later operation in the prognosis extent of follow-up 3 months after discharge from hospital,and there was no difference in interventional embolization group.3.For the interventional emmbolization treatment of the ruptured anterior communicating artery aneurysm the length of staying was short?postoperative recovery quick?cost of hospitalization high;while for craniotomy clipping length of staying long?postoperative recovery slow?low cost of hospitalization.4.There were no significant difference in the surgical complications?the degree of discharge recovery and prognosis extent of follow-up 3 months after discharge from hospital of the two surgical approaches.5.There were no difference of early operation between two groups in the discharge recovery extent and prognosis extent of follow-up 3 months after discharge from hospital,as well as late operation.