早期介入栓塞治疗脑动脉瘤破裂的疗效及安全性评价  

The curative effect of early interventional embolization of cerebral aneurysms and safety evaluation

作　　者：张茂[1] 陈建龙[1] 

机构地区：[1]海南省人民医院神经外科,海南海口570311

出　　处：《临床和实验医学杂志》2016年第21期2135-2137,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨早期介入栓塞治疗脑动脉瘤破裂的疗效及安全性。方法选择脑动脉瘤破裂患者106例为研究对象,采用随机数字表法分为分为早期治疗组(53例)和对照组(53例),均采用微弹簧圈栓塞形式介入治疗。早期治疗组于患者入院3 d内实施治疗,对照组于患者入院3 d后实施治疗。术后进行脑血管造影评价栓塞效果,记录术后并发症发生情况,术后随访6个月进行Rankin量表(改良mRS)和改良Barthel(MBI)评分评价远期疗效。结果早期治疗组的完全栓塞率显著高于对照组(88.68%vs.52.83%),次完全栓塞率和不完全栓塞率显著低于对照组(9.43%vs.30.19%和1.89%vs.16.98%),差异有显著性(P<0.05)。随访6个月复查,早期治疗组患者mRS评分为(1.15±0.28)分,显著低于对照组的(2.43±0.75)分,组间比较差异有显著性(P<0.01)。早期治疗组患者的MBI评分为(98.63±1.24)分,显著高于对照组的(80.14±2.56)分,组间比较差异显著(P<0.01)。早期治疗组脑积水、蛛网膜下腔出血、动脉瘤再次破裂、脑血管痉挛和复发的发生率分别为1.89%、5.66%、1.89%、1.89%和3.77%,明显低于对照组的13.21%、18.86%、11.32%、13.21%和16.98%,组间比较差异均有显著性(P<0.05)。结论早期介入栓塞治疗脑动脉瘤破裂能够进一步提高栓塞效果,改善预后,降低术后并发症的发生率。Objective To discuss the curative effect of early interventional embolization of cerebral aneurysms and security. Methods One hundred and six cases of patients with cerebral aneurysm rupture were selected as the research object, using the random number table method, who were divided into early treatment group （53 cases） and control group （53 cases）. All patients adopt the form of spring coil embolization inter- vention treatment. Early treatment group patients accepted treatment within 3 d and the control group in patients after 3 d treatment. Postoperative cerebral tmg^ogrnphy were performed to evaluate therapeutic effect, the postoperative complications were recorded, postoperative follow - up of 6 months to mRS grading and evaluation of MBI scores long curative effect in price. Results Complete embolism rate, rate of thrombosis and incom- plete thrombosis in early treatment group was 88..68%, 9.43% and 88.68% respectively, compared with the control group 52.83%, 30. 19% and 52.83 % , the difference were significant （ P 〈 0.05 ）. Review were followed up for 6 months, patientsfor mRS score points （ 1.15 4± 0. 28） in early treatment group was significantly lower than that of the control group （2.43± 0.75 ） points. There was significant difference between the two groups （ P 〈0. 01 ）. The MBI scores for patients in early treatment group （98.63 ±1.24） was significantly higher than that of control group （ 80.14 ± 2.56） points, there was significant different between the two groups （ P 〈 0. 01 ）. Hydrocephalus, subarachnoid hemorrhage, aneurysm rupture again, the incidence of cerebral vasospasm and recurrence in early treatment group were 1.89%, 5.66%, 1.89%, 1.89% and 3.77%, were significantly lower than those in the control group 13.21%, 18.86%, 11.32%, 13.21% and 16.98%. The differences were significant （ P 〈0. 05）. Conclusion Early interventional embolization of cerebral aneurysms can further improve the therapeutic effect, improve prognosis and reduce the incide

关 键 词：脑动脉瘤 早期介入栓塞 微弹簧圈栓塞 临床疗效 安全性 

分 类 号：R651.12[医药卫生—外科学]