| Objective:Compare the efficacy of craniotomy clipping and interventional embolization in the treatment of elderly low-grade anterior communicating artery aneurysms,in order to provide certain guidance and assistance for clinical workers in the treatment of elderly low-grade anterior communicating artery aneurysms.Methods:A total of 215 elderly patients with anterior communicating artery aneurysms admitted to the Second Affiliated Hospital of Nanchang University from June 2014 to August 2022 were retrospectively collected.According to the inclusion and exclusion criteria,patient data was screened,and a total of 82 patients were selected,including44 patients who underwent arterial aneurysm clipping surgery and 38 patients who underwent arterial aneurysm embolization surgery.By analyzing and comparing clinical data of patients,we preliminarily explore the efficacy of craniotomy clipping surgery and interventional embolization surgery in the treatment of low-grade anterior communicating artery aneurysms in the elderly.Results:1.The good prognosis rate after 6 months in the craniotomy group was 79.5%(35/44),while the good prognosis rate after 6 months in the intervention group was94.7%(36/38).The difference between the two groups was statistically significant(P<0.05),and the good prognosis rate after 6 months in the intervention group was higher.2.At the end of the craniotomy group,2 patients had residual aneurysms(all of which were residual aneurysms),42 patients had completely occluded aneurysms,with a residual rate of 4.5%(2/44),9 patients in the intervention group had residual aneurysms(8 had residual aneurysms,and 1 had residual tumor bodies),and 29 patients had completely embolized aneurysms,with a residual rate of 23.7%(9/38).The difference between the two groups was statistically significant(P<0.05),and the complete occlusion rate at the end of the craniotomy group was higher.3.No patients in the craniotomy group experienced aneurysm recurrence at 6months after surgery,with a recurrence rate of 0%(0/35).In the intervention group,3patients experienced aneurysm recurrence at 6 months after surgery,with a recurrence rate of 8.3%(3/36).There was no statistically significant difference between the two groups(P>0.05).4.The incidence of postoperative pulmonary infection in the craniotomy group was 22.7%(10/44),while in the intervention group it was 5.3%(2/38).The difference between the two groups was statistically significant(P<0.05),and the incidence of pulmonary infection in the craniotomy group was higher.There was no statistically significant difference in the incidence of other complications(P>0.05).5.The average hospital stay in the craniotomy group was 13.20 ± 4.64 days,while the average hospital stay in the intervention group was 6.35 ± 2.27 days.The difference between the two groups was statistically significant(P < 0.05),and the average hospital stay in the intervention group was shorter.6.The actual self-paid expenses after medical insurance reimbursement in the craniotomy group were 57736.21 ± 32015.19 yuan,while the actual self-paid expenses after medical insurance reimbursement in the intervention group were111547.13 ± 43196.62 yuan.The difference between the two groups was statistically significant(P<0.05).The actual self-paid expenses for the intervention group after medical insurance reimbursement are higher.Conclusion:1.For elderly patients with low-grade anterior communicating artery aneurysms,although interventional embolization is expensive and prone to residual complications,the hospital stay is short and the long-term efficacy is significantly higher than craniotomy clipping surgery.It is recommended to be the first choice for elderly patients.2.The cost of craniotomy clipping surgery is relatively low and it is easy to completely clamp,but it is prone to pulmonary infection after surgery.For elderly patients who choose craniotomy due to financial constraints,it is necessary to strengthen respiratory management to reduce the chances of infection. |
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