夹闭术与栓塞治疗对颅内破裂动脉瘤病人局部脑氧饱和度的影响  

Effects of clipping and endovascular embolization on regional cerebral oxygenation in patients with ruptured intracranial aneurysm

作　　者：丁昊[1] 陈岷辉[1] 陈立珂[1] 杨呈浩[1] 蓝美锐[1] DING Hao;CHEN Min-hui;Chen Li-ke;YANG Cheng-hao;LAN Mei-rui(Department of Neurosurgery, The Fourth People's Hospital of Zigong City, Zigong 643000, China)

机构地区：[1]自贡市第四人民医院神经外科,四川643000

出　　处：《中国临床神经外科杂志》2019年第1期29-30,34,共3页Chinese Journal of Clinical Neurosurgery

基　　金：四川省卫生计生委科研课题(140110)

摘　　要：目的探讨开颅夹闭术及栓塞治疗对颅内破裂动脉瘤病人局部脑氧饱和度(rScO_2)的影响。方法回顾性分析2016年9月至2018年5月收治的45例颅内破裂动脉瘤的临床资料。开颅夹闭术治疗30例(夹闭组),栓塞治疗15例(栓塞组)。入院时、术后1、2、3、7 d采用近红外光谱技术监测rScO_2。结果夹闭组术后2、3 d rScO_2较术前明显降低(P<0.05);而栓塞组术后1、2、3、7 d rScO_2均无明显变化(P>0.05)。术后2、3 d,夹闭组rScO_2明显低于栓塞组(P<0.05),但术后7 d两组rScO_2无明显差异(P>0.05)。结论与栓塞治疗比较,开颅夹闭术对颅内破裂动脉瘤术后早期rScO_2有一定影响。Objective To explore the regional cerebral oxygenation (rScO2) in the patients with ruptured intracranial aneurysms (rICA) after the clipping and endovascular embolization. Methods Of 45 patients with rICA, 30 underwent microsurgical clipping and 15 endovascular embolization. The rScO2 was determined by near infrared spectroscopy technology (NIRS) before and 1, 2, 3 and 7 days after the operation in all the patients. Results The level of rScO2 was significantly lower in the clipping group than that in the embolization group 2 days after the operation (P<0.05). The levels of rScO2 2 and 3 days after the operation were significantly lower than that before the operation in the clipping group (P<0.05), but there were insignificant differences in the levels of rScO2 among 1, 2, 3 and 7 days after the operation (P>0.05) and between 1 or 2 or 3 or 7 days after the operation and before the operation in the embolization group (P>0.05). Conclusions Compared with the embolization, the clipping has some bad effects on rScO2 level early after the operation, but there was no significant effect of the clipping on rScO2 late after the operation in the patients with rICA.

关 键 词：颅内破裂动脉瘤 栓塞治疗 夹闭术 局部脑氧饱和度 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R651.12[医药卫生—临床医学]