【摘要】：目的:探討前交通動脈瘤最佳的手術方式，為以后的治療提供理論依據。 方法:通過檢索Science-Direct、PubMed、Cochrane Library、中國生物醫(yī)學文獻數(shù)據庫（CMB）、相關期刊論文(CNKI)、萬方數(shù)據庫等國內外的文獻資料庫，搜集2000年1月1日至2014年6月30日關于外科手術對前交通動脈瘤的病例對照文獻，并補充檢索納入研究的參考文獻，，仔細分析文獻，根據相關標準納入和排除文獻、整理信息資料并使用Cochrane對資料進行質量評價，使用ＲevMan5．1軟件對文獻中手術治療方式及治療效果、并發(fā)癥等相關結果進行Meta分析。 結果:系統(tǒng)分析資料后，有12篇回顧性分析文獻共9955名診斷明確的前交通動脈瘤患者納入研究，在這些患者中有4855名進行了介入栓塞手術治療，有5100名進行了開顱顯微手術夾閉治療。Meta分析結果顯示:介入栓塞術較開顱顯微夾閉后住院時間短（P=0.005）、電解質紊亂發(fā)生率低（P=0.02），差異具有統(tǒng)計學意義，而在腦積水、血管痙攣、再出血、致殘率等方面無統(tǒng)計學意義(均P0.05)，栓塞患者復發(fā)率稍高(P0.01)，差異具有統(tǒng)計學意義。 結論:介入栓塞具有不需開顱、對腦組織副損傷小、住院時間短、術后恢復快、電解質紊亂發(fā)生率低等優(yōu)勢。前交通動脈瘤栓塞與夾閉在再出血、腦積水、腦血管痙攣、致殘率等方面無差異，但動脈瘤復發(fā)率高。前交通動脈瘤治療建議首選介入栓塞，但要求臨床醫(yī)師具有豐富的經驗、精湛的技術及先進的設備，達到致密栓塞動脈瘤，降低復發(fā)率。
[Abstract]:Objective: to explore the best operation method of anterior communicating aneurysm and to provide theoretical basis for the treatment of anterior communicating artery aneurysm. Methods: by searching Science-Direct,PubMed,Cochrane Library, Chinese biomedical literature database (CMB), Chinese periodical full-text database (CNKI), Wanfang database and other domestic and foreign literature databases. To collect the case-control literature on surgical treatment of anterior communicating aneurysms from January 1, 2000 to June 30, 2014, and to supplement and retrieve the references that were included in the study, to analyze the literature carefully, and to include and exclude the literature according to the relevant standards, The quality of the data was evaluated by Cochrane, and the results of surgical treatment and treatment, complications and other related results were analyzed by Meta using RevMan5.1 software. Results: after systematic analysis, 9955 patients with clearly diagnosed anterior communicating aneurysms were included in the study, and 4855 of them underwent interventional embolization. The results of Meta analysis showed that the hospitalization time of interventional embolization was shorter than that of open microclipping (P0. 005), and the incidence of electrolyte disturbance was lower (P0. 02), the difference was statistically significant. There was no significant difference in hydrocephalus, vasospasm, rebleeding, disability rate (P0.05), the recurrence rate of embolism patients was higher (P0.01), the difference was statistically significant. Conclusion: interventional embolization has the advantages of no craniotomy, less injury to brain tissue, short hospitalization time, quick recovery after operation and low incidence of electrolyte disturbance. There was no difference between embolization and clipping of anterior communicating artery aneurysm in rebleeding, hydrocephalus, cerebral vasospasm and disability rate, but the recurrence rate of aneurysm was high. Interventional embolization is the first choice in the treatment of anterior communicating aneurysm, but the clinician is required to have rich experience, consummate technique and advanced equipment to embolize the aneurysm compactly and reduce the recurrence rate.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R651.1

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