摘要
目的观察血管介入栓塞术治疗颅内动脉瘤破裂蛛网膜下腔出血的临床疗效,并与传统开放血管夹闭术进行比较,以期为临床诊疗提供参考。方法分析2014年1月至2016年1月在我院接受治疗的颅内动脉瘤破裂蛛网膜下腔出血患者的临床资料。依据手术方式不同将患者分为观察组(血管介入栓塞术)及对照组(开颅血管夹闭术)。共纳入观察组患者176例,对照组患者120例。比较两组患者术后脑血管痉挛累积发生率。比较两组患者术前及术后48h外周血炎症指标,包括:C-反应蛋白(CRP)、白介素-8(IL-8)及IL-10。采用神经功能缺损量表(NDS)评估两组患者术后6个月神经功能缺损情况。结果观察组患者术后脑血管痉挛累积发生率显著低于对照组患者,具有统计学差异(10.80%,19/176vs 21.67%,26/120;Log-rankχ~2=6.723,P<0.01)。术后,两组患者CRP及IL-8水平均显著升高(P<0.05),但观察组患者显著低于对照组(P<0.05)。两组患者治疗前后IL-10水平未见显著差异(P>0.05)。两组患者均未出现围手术期死亡病例。术后观察组患者获得轻度(χ~2=4.984,P=0.026)及中度(χ~2=7.878,P=0.005)神经功能缺损的比例显著高于对照组,而重度神经功能缺损的比例显著低于对照组(χ~2=9.451,P=0.002)。结论血管介入栓塞治疗颅内动脉破裂蛛网膜下腔出血的近、远期疗效可靠。
Objective Our study was aimed toanalyze the clinical efficacy of endovascular coil occlusion in the treatment of subarachnoid hemorrhage caused by ruptured intracranial aneurysms.Methods Clinical data of patients with subarachnoid hemorrhage caused by ruptured intracranial aneurysmsreceived surgery treatment at our hospitalfrom 2014 to 2016 were analyzed.Patients were divided into two groups by therapeutic methods,Group A：endovascular coil occlusion;Group B：angiotomy.Results A total of 296 patients were analyzed,Group A 176 cases,Group B 120 cases.Group A patients had lower accumulate incidence of cerebral angiospasm than that of Group B,the difference was statistically significant（10.80%,19/176 vs 21.67%,26/120;Log-rankχ^2=6.723,P〈0.01）.48 hours after surgery,both of the two groups got significantly decreased in CRP and IL-8（P〈0.05）,however,these index were lower in Group A when compared with those of Group B（P〈0.05）.These was no significant difference of IL-10 between the two group before and after treatment（P〉0.05）.Six months after treatment,the Group A patients got higher rate of mild（χ^2=4.984,P=0.026）and moderate（χ^2=7.878,P=0.005）neurologic impairment but a lower severe moderate neurologic impairment than these of Group B patients（χ2=9.451,P=0.002）.Conclusion The treatment of subarachnoid hemorrhage caused by ruptured intracranial aneurysms,endovascular coil occlusion showed an ideal clinical efficacy.
作者
彭华
Peng Hua.(Department of neurosurgery ,Affiliated Hospital of Chuanbei Medical College, Nanchong, 621000, P. R. China)
出处
《立体定向和功能性神经外科杂志》
2018年第1期43-46,共4页
Chinese Journal of Stereotactic and Functional Neurosurgery
关键词
颅内动脉瘤
蛛网膜下腔出血
血管介入栓塞术
神经功能
微创
Intracranial aneurysm
Subarachnoid hemorrhage
Endovascular coil occlusion
Neurological function
Minimally invasive
