动脉瘤性蛛网膜下腔出血患者夹闭和栓塞术治疗后全身代谢与能量消耗的变化研究  

Changes of systemic metabolism and energy expenditure in patients with aneurysmal subarachnoid hemorrhage after clipping and coiling

作　　者：王建伟 Wang Jianwei(Department of Neurosurgery,Yulin Xingyuan Hospital,Shaanxi719000,China)

机构地区：[1]陕西省榆林市星元(第四)医院神经外科

出　　处：《山西医药杂志》2019年第18期2214-2217,共4页Shanxi Medical Journal

摘　　要：目的探讨动脉瘤性蛛网膜下腔出血(aSAH)患者夹闭和栓塞术治疗后全身代谢与能量消耗的变化。方法回顾性分析2015年1月至2017年12月来我院接受外科治疗的aSAH患者92例作为研究对象。根据外科治疗方式分为手术夹闭法(夹闭组48例)和介入栓塞术(栓塞组44例)。比较2组患者在临床资料、术后不同天数静息能量消耗(REE)/基础能量消耗(BEE)比值、前白蛋白及C反应蛋白水平方面的差异。结果2组患者临床资料差异无统计学意义(P>0.05),研究对象具有可比性。2组患者在术后第7天、10天、13天、16天、21天REE/BEE比值方面差异无统计学意义(P>0.05),夹闭组在术后第1天、4天REE/BEE比值方面显著高于栓塞组(P<0.05)。2组患者在术后第1天、7天、10天、13天、16天、21天前白蛋白水平方面差异无统计学意义(P>0.05),夹闭组在术后第4天前白蛋白水平方面显著低于栓塞组(P<0.05);2组患者在术后第10天、13天、16天、21天C反应蛋白水平方面差异无统计学意义(P>0.05),夹闭组在术后第1天、4天、7天C反应蛋白水平方面显著高于栓塞组(P<0.05)。结论相比栓塞术,行夹闭术治疗的aSAH患者在术后早期更易出现高代谢状态。Objective To investigate the changes of systemic metabolism and energy expenditure in patients with aneurysmal subarachnoid hemorrhage(aSAH)after clipping and coiling.Methods Ninety-two patients with aSAH surgically treated in our hospital from Jan 2015 to Dec 2017 were selected as study subjects.The patients were divided into clipping group(n=48)and coiling group(n=44)according to the surgical treatment.The clinical data,postoperative REE/BEE ratio,prealbumin and C-reactive protein level in different days of two groups were compared.Results There was no significant difference in clinical data between the two groups(P>0.05),and the subjects were comparable.There was no significant difference in the ratio of REE/BEE of 7 d,10 d,13 d,16 d and 21 d in the two groups(P>0.05).The ratio of REE/BEE of 1d and 4 d in the clipping group was significantly higher than that in the coiling group(P<0.05).There was no significant difference between the two groups in the level of prealbumin in 1 d,7 d,10 d,13 d,16 d and 21 d after operation(P>0.05),the level of prealbumin in the clipping group was significantly lower than that in the coiling group in 4 d after operation(P<0.05);There was no significant difference in the level of C-reactive protein in 10 d,13 d,16 d and 21d(P>0.05)in the two groups,the level of C-reactive protein of 1d,4d and 7d in the clipping group was significantly higher than that in the coiling group after operation(P<0.05).Conclusions Compared with coiling,aSAH patients who underwent clipping are more likely to have high metabolic status at the early stage after operation.

关 键 词：蛛网膜下腔出血 显微外科手术 基础代谢 

分 类 号：R74[医药卫生—神经病学与精神病学]