| Objecives To analyzethe effect of craniotomy and interventional embolization in the treatment of middle cerebral artery aneurysm,and to provide a reference for the clinial treatment of middle cerebral artery aneurysm.Methods A total of 61 patients with middle cerebral aneurysms undergoing craniotomy clipping and interventional embolization in our neurosurgery from January 2015 to December 2020 were collected,and 30 cases were selected into clipping group(control group),which used the traditional wing point approach to clip aneurysm,and 31 patients were assigned into embolization group(observation group),which used simple coil embolization or stent-assisted embolization,and all of the patients were followed up for 6 months.The general data,intraoperative and postoperative complications,immediate postoperative complete clipping rate,good prognosis at discharge(m RS≤2),recurrence rate of 6 months after discharge and good prognosis at 6 months followup(m RS≤2)between the two groups were compared,and the operation time,length of stay and hospitalization costs of both groups were also analyzed.Results1.There were no significant differences in sex,age,hunt-hess grade at admission,prevalence of hypertension,diabetes mellitus,aneurysm side division,location,rupture and nonrupture,width of tumor neck,and tumor height,p> 0.05.2.In the control group,the immediate postoperative complete occlusion rate was 100%(30 patients).In the observation group,the immediate postoperative complete occlusion rate was 84%(26 patients),there was no significant differnece between two groups(P>0.05).3.The incidence of intraoperative and postoperative complications in the control group was 43.3%(13 cases)and 16.1%(5 cases)in the observed group,and there was statistical difference between the two groups(p <0.05).4.Good prognosis rate at discharge in the control group was 83.3%(25 cases),and in the observation group was 90.3%(28 cases),and there was no significant differnece between two groups(P>0.05).5.The recurrence rate and good prognosis(m RS≤2)at 6 months follow up were 0.0%(0cases)and 83.3%(25 cases)respectively in the control group,and were 8.33%(1 cases)and 93.5%(29 cases)in the observation group,with no statistical difference between the two groups(p> 0.05).6.Compared with the control group,the operation time(3.83±1.39 h vs 2.32±1.08 h,P<0.001)was significantly shorten in the observation group.7.The hospitalization expense was 55922.81±36042.11 RMB in the control group and 132929.79±58739.70 RMB in the observation group,there was significant difference between to groups(P<0.001).The length of hospital stay in the control group was longer than that of observation group(15.90±6.75 days vs 11.65±5.17 days,P<0.05).Conclusions1.The complete occlusion rate of the clipping group is higher,but the trauma is relatively large;the embolic group has fewer surgical complications than the clipping group,and the hospital stay is shorter than the clipping group,and the patients recover faster,but the cost is high.2.Both clipping and embolism are effective methods for treating middle cerebral artery aneurysm.However,because interventional embolization has a low complication rate,small trauma and short operation time,so the economic conditions permit,interventional embolization treatment should be chosen as far as possible. |
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