介入栓塞术与手术夹闭法治疗动脉瘤性蛛网膜下腔出血临床效果的比较研究  

Comparative Study for Clinical Effect on Aneurysmal Subarachnoid Hemorrhage Between Interventional Embolization and Surgical Clipping Therapy

作　　者：温江[1] 

机构地区：[1]四川省绵竹市人民医院神经外科,618200

出　　处：《实用心脑肺血管病杂志》2016年第1期47-50,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的比较介入栓塞术与手术夹闭法治疗动脉瘤性蛛网膜下腔出血(a SAH)的临床效果。方法选取绵竹市人民医院2010年8月—2015年2月收治的a SAH患者62例,随机分为对照组30例和观察组32例。观察组患者采用介入栓塞术治疗,对照组患者采用手术夹闭法治疗。比较两组短期预后及并发症发生率,术前及术后第1、3天免疫功能指标(IgG、IgM及IgA),手术前后血清类胰岛素一号生长因子(IGF-1)、可溶性细胞间黏附分子-1(s ICAM-1)及可溶性血管细胞黏附分子-1(s VCAM-1)水平。结果观察组患者短期预后优于对照组(u=-1.754,P=0.040)。术前两组患者IgG、IgM及IgA水平比较,差异无统计学意义(P>0.05);术后第1、3天观察组患者IgG、IgM及IgA水平均高于对照组(P<0.05)。术前两组患者血清IGF-1、s ICAM-1及s VCAM-1水平比较,差异无统计学意义(P>0.05);术后观察组患者血清IGF-1、sICAM-1及sVCAM-1水平低于对照组(P<0.05)。观察组患者术后并发症发生率为18.8%,低于对照组的50.0%(P<0.05)。结论与手术夹闭法相比,介入栓塞术治疗a SAH的临床效果更佳,对患者免疫功能影响较小。Objective To compare the clinical effect on aneurysmal subarachnoid hemorrhage between interventional embolization and surgical clipping therapy. Methods A total of 62 patients with aneurysmal subarachnoid hemorrhage were selected in the People＇s Hospital of Mianzhu from August 2010 to February 2015,and they were randomly divided into control group（ n = 30） and observation group（ n = 32）. Patients of control group received surgical clipping therapy,while patients of observation group received interventional embolization. Short- term prognosis,incidence of complications,immunologic function index（ including serum levels of Ig G,Ig M and Ig A） before surgery and on the first,third day of surgery, serum levels of IGF-1,s ICAM-1 and s VCAM-1 before and after surgery were compared between the two groups. Results The short- term prognosis of observation group was statistically significantly better than that of control group（ u =- 1. 754,P = 0. 040）. No statistically significant differences of serum level of Ig G,Ig M or Ig A was found between the two groups before surgery（ P 0. 05）,while serum levels of Ig G,Ig M and Ig A of observation group were statistically significantly higher than those of control group on the first and third day of surgery（ P〈0. 05）. No statistically significant differences of serum level of IGF-1,s ICAM-1or s VCAM-1 was found between the two groups before surgery（ P〈0. 05）,while serum levels of IGF-1,s ICAM-1 and s VCAM-1of observation group were statistically significantly lower than those of control group after surgery. The incidence of complications of observation group was 18. 8%,was statistically significantly lower than that of control group of 50. 0%（ P〈0. 05）. Conclusion Compared with surgical clipping therapy,interventional embolization has better clinical effect and less impact on immunologic function in treating patients with aneurysmal subarachnoid hemorrhage.

关 键 词：蛛网膜下腔出血 介入栓塞 手术夹闭 疗效比较研究 

分 类 号：R743.35[医药卫生—神经病学与精神病学]