Comparison of microsurgical clipping and intravascular interventional embolization on nerve function recovery in patients with posterior communicating aneurysm combined with oculomotor paralyses

Q4 Medicine 中国医师杂志 Pub Date : 2020-02-29 DOI:10.3760/CMA.J.ISSN.1008-1372.2020.02.019

Shengwei Zou, Huaizhong Huang, Jun Liu, Jian-hua Xiong

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Abstract

Objective To compare the influences of microsurgical clipping and intravascular interventional embolization on the nerve function recovery in patients with posterior communicating aneurysm combined with oculomotor paralyses. Methods Eighty-six patients with posterior communicating artery aneurysm accompanied by oculomotor nerve palsy admitted to Qianjiang Central Hospital of Chongqing from May 2015 to May 2017 were randomly divided into observation group (n=43) and control group (n=43) by random number table method. The control group was treated with microsurgical clipping, while the observation group was treated with intravascular interventional embolization. The therapeutic effect, neurological function recovery, postoperative complications and prognosis of the two groups were compared. Results The operation time, intraoperative blood loss, postoperative respiratory recovery time and postoperative extubation time of the observation group were significantly less than those of the control group (P<0.05); the complete recovery of the observation group was significantly higher than that of the control group, and no recovery was significantly lower than that of the control group (P<0.05); the incidence of complications in the observation group was significantly lower than that in the control group (P<0.05); the proportion of 5 points in the observation group was significantly higher than that in the control group (P<0.05). Conclusions Intravascular interventional embolization in the treatment of posterior communicating aneurysm combined with oculomotor paralyses can promote the recovery of nerve function, reduce the incidence of postoperative complications, have a good prognosis and a definite effect, which can be used as the first choice of treatment. Key words: Microsurgery; Microsurgical clipping; Intravascular interventional emboliization; Posterior communicating aneurysm; Oculomotor paralyses; Nerve function

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显微外科夹持与血管内介入栓塞对后交通动脉瘤合并动眼肌麻痹患者神经功能恢复的影响比较

目的比较显微外科夹持术与血管内介入栓塞术对后交通动脉瘤合并动眼肌麻痹患者神经功能恢复的影响。方法选取2015年5月至2017年5月重庆钱江中心医院收治的86例后交通动脉瘤合并动眼神经麻痹患者，采用随机数字表法随机分为观察组(n=43)和对照组(n=43)。对照组采用显微外科夹持治疗，观察组采用血管内介入栓塞治疗。比较两组患者的治疗效果、神经功能恢复情况、术后并发症及预后。结果观察组患者手术时间、术中出血量、术后呼吸恢复时间、术后拔管时间均显著少于对照组(P<0.05);观察组患者完全康复率显著高于对照组，无康复率显著低于对照组(P<0.05);观察组并发症发生率显著低于对照组(P<0.05);观察组5分占比显著高于对照组(P<0.05)。结论血管内介入栓塞治疗后交通动脉瘤合并动眼肌麻痹可促进神经功能恢复，减少术后并发症的发生，预后良好，效果明确，可作为首选治疗方法。关键词:显微外科;显微外科剪裁;血管内介入栓塞;后交通动脉瘤;眼球运动的瘫痪;神经功能

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