不同时机行血管内介入栓塞术治疗低级别颅内动脉瘤破裂出血的临床效果  

Clinical efficacy of endovascular interventional embolization at different time points for treating low-grade intracranial aneurysm rupture and hemorrhage

作　　者：宾杰 姚洁民[1] 朱晟[1] 郭春雨[1] 李智恒 BIN Jie;YAO Jie-min;ZHU Sheng;GUO Chun-yu;LI Zhi-heng(Department of Neurosurgery,the Second People′s Hospital of Nanning,Nanning 530031,China)

机构地区：[1]广西南宁市第二人民医院神经外科

出　　处：《广西医学》2019年第22期2850-2853,共4页Guangxi Medical Journal

摘　　要：目的比较不同时机行血管内介入栓塞治疗低级别颅内动脉瘤破裂出血的临床效果。方法纳入147例低级别(Hunt-Hess分级Ⅰ~Ⅲ级)颅内动脉瘤破裂出血患者,根据手术时间分为超早期栓塞组(手术距发病时间<48 h)41例、早期栓塞组(手术距发病时间48~72 h)47例、延期栓塞组(手术距发病时间>72 h)59例。3组患者在相应时间段施行血管内介入栓塞术治疗。比较3组患者栓塞成功率、术中和术后并发症发生率及短期预后情况。结果超早期栓塞组、早期栓塞组患者栓塞成功率分别为97.56%、89.36%,均高于延期栓塞组的81.36%,术后再出血率分别2.44%、4.26%,均低于延期栓塞组的16.94%(均P<0.05)。超早期栓塞组、早期栓塞组短期预后优于延期栓塞组(P<0.05)。结论对于低级别颅内动脉瘤破裂出血患者,超早期或早期行血管内介入栓塞治疗,栓塞成功率高,术后再出血发生率低,短期预后佳。Objective To compare the clinical efficacy of endovascular interventional embolization at different time points for treating low-grade intracranial aneurysms rupture and hemorrhage.Methods A total of 147 patients with low-grade(grade Ⅰ-Ⅲ of Hunt-Hess classification) intracranial aneurysms rupture and hemorrhage were enrolled,and were divided into ultra-early embolization group(the duration between operation and onset was shorter than 48 h,41 cases),early embolization group(the duration between operation and onset was from 48 h to 72 h,47 cases) and delayed embolization group(the duration between operation and onset was longer than 72 h,59 cases) in accordance with the time point for surgery.Endovascular interventional embolization was conducted in the patients of the three groups at corresponding time point.The success rates of interventional embolization,incidence of intraoperative and postoperative complications,and short-term prognosis were compared between the three groups.Results The success rate of embolization in the ultra-early group or early embolization groups was higher than that in the delayed embolization group(97.56%,89.36% and 81.36% respectively,all P<0.05);the incidence rate of postoperative re-bleeding in the ultra-early group or early embolization group was lower than that in the delayed embolization group(2.44%,4.26% and 16.94% respectively,all P<0.05).The short-term prognosis of the ultra-early group or early embolization group was superior to that of the delayed embolization group(P<0.05).Conclusion In allusion to patients with low-grade intracranial aneurysms rupture and hemorrhage,ultra-early or early endovascular interventional embolization obtains a high success rate of embolization,a low incidence of postoperative re-bleeding,and a preferable short-term prognosis.

关 键 词：低级别颅内动脉瘤 破裂出血 血管内介入栓塞 治疗时机 临床效果 

分 类 号：R743.9[医药卫生—神经病学与精神病学]