血管内介入栓塞术治疗脑动脉瘤对患者神经功能及预后的影响  

Clinical effect of endovascular embolization on neurological function and prognosis in patients with cerebral aneurysms

作　　者：郭文[1] 吐尔洪·吐尔逊[1] 王增亮[2] 马龙[1] 李晓鹏[1] 于湘友[1] GUO Wen;Tuerhon Tuerxun;WANG Zeng-liang;MA Long;LI Xiao-peng;YU Xiang-you(Department of Critical Care Medicine,First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830011,China)

机构地区：[1]新疆医科大学第一附属医院重症医学科,新疆乌鲁木齐830011 [2]新疆医科大学第一附属医院神经外科,新疆乌鲁木齐830011

出　　处：《中国临床研究》2019年第10期1346-1349,共4页Chinese Journal of Clinical Research

基　　金：国家自然科学基金青年科学基金(81801232)~~

摘　　要：目的探讨脑动脉瘤应用血管内介入栓塞术的临床效果及对患者神经功能和预后的影响。方法采用回顾性研究方法,按照治疗方法不同将2016年5月至2018年5月收治的脑动脉瘤患者84例分为两组,各42例,对照组应用开颅夹闭术治疗,研究组应用血管内介入栓塞术治疗。观察两组患者手术相关指标及并发症情况;术后6个月采用格拉斯哥预后评分评定两组患者术后预后情况,并比较复发率;采用美国国立卫生研究院卒中量表(NIHSS)评估两组患者术前术后神经功能。结果研究组手术成功率与对照组无明显差异(P>0.05);研究组手术时间及住院时间短于对照组(P均<0.01),并发症发生率低于对照组(26.2%vs64.3%,P<0.01),复发率与对照组比较无统计学差异(P>0.05)。研究组预后(研究组和对照组分别为死亡0例、2例,植物生存1例、3例,重度残疾1例、4例,轻度残疾5例、12例,恢复良好35例、21例)优于对照组(P<0.01)。两组治疗后Baethel指数评分高于治疗前,且研究组高于对照组(P均<0.01);NIHSS评分低于治疗前,且研究组低于对照组(P均<0.01)。结论脑动脉瘤采用血管内介入栓塞术治疗,可以提高恢复良好率,降低并发症率,缩短手术时间和住院时间,促进患者神经功能恢复。Objective To investigate the clinical effect of endovascular embolization for cerebral aneurysms and its influence on neurological function and prognosis of patients. Methods By using the methol of restrospective research, 84 patients with cerebral aneurysms admitted between May 2016 and May 2018 were selected and divided into control group (received neurosurgical clipping, n = 42 ) and study group (received endovascular embolization, n = 42 ) according to the different treatment. The surgical related indexes and complications were observed in the two groups. The postoperative prognosis of the two groups was evaluated by Glasgow outcome score at 6 months postoperatively, and the recurrence rate was compared. The Glasgow prognosis score was used to analyze the recovery of the patients. The neurological function of the patients was assessed by the National Institutes of Health Stroke Scale ( NIHSS) before and after operation in two groups. Results There was no significant difference in the success rate and recurrence rate between the study group and the control group ( all P > 0. 05 ). The operation time and hospitalization time in the study group were shorter than those in the control group ( all P <0. 01 ). Incidences of complications in the study group were lower than that in the control group (P <0. 01). The prognosis of the study group was better than that of the control group (P <0. 01 ). After treatment,the BI score of the two groups was higher than that before treatment, and the BI score of the study group was higher than that of the control group ( all P <0. 01);while the NIHSS score of the two groups was lower than that before treatment, and the NIHSS score of the study group was lower than that of the control group ( all P <0. 01). Conclusion Endovascular embolization for cerebral aneurysms can improve the recovery rate, reduce complications, shorten the operation time and hospitalization time, and promote the recovery of neurological function.

关 键 词：脑动脉瘤 开颅夹闭术 血管内介入栓塞术 神经功能 预后 

分 类 号：R743.4[医药卫生—神经病学与精神病学]