不同介入手术治疗时机对颅内动脉瘤患者完全栓塞率和预后的效果评价  

Evaluation of the effect of different treatment opportunities for interventional operations on the complete embolization rate and prognosis effect of patients with intracranial aneurysms

作　　者：陈泽鑫[1] 蔡洁波[1] 黄广俊 CHEN Zexin;CAI Jiebo;HUANG Guangjun(Third Department of Neurosurgery,Jieyang People’s Hospital,Jieyang 522095,China)

机构地区：[1]广东省揭阳市人民医院神经外三科,广东揭阳522095

出　　处：《中国医药科学》2020年第4期240-242,246,共4页China Medicine And Pharmacy

摘　　要：目的分析不同介入手术治疗时机对颅内动脉瘤患者的完全栓塞率及其预后效果。方法择取2015年5月~2018年12月本院收治颅内动脉瘤患者100例,将入组患者分成早晚期治疗两组,所有患者均进行血管内的栓塞治疗,记录两组患者的栓塞情况、预后的GCS评分、改良Barthel指数量表评分及并发症的发病率。结果 (1)早期治疗组中,44例患者为完全栓塞,5例患者是大部分栓塞,1例患者是部分栓塞,完全栓塞率为88%;晚期治疗组中,25例患者为完全栓塞,13例患者是大部分栓塞,12例患者是部分栓塞,完全栓塞率为50%;(2)早期治疗组中,有2例为脑梗死,2例为下肢静脉血栓,3例为脑积水,2例为破裂再出血,5例为脑血管痉挛,并发症的发生率是28%;晚期治疗组中,有8例为脑梗死,6例为下肢静脉血栓,5例为脑积水,3例为破裂再出血,10例为脑血管痉挛,并发症的发生率是64%;(3)早期治疗组的GCS评分为(13.2±1.8)分,Barthel指数为(82.8±7.8),晚期治疗组的GCS评分为(13.9±2.0)分,Barthel指数为(70.5±5.5)。结论早期的介入治疗对患者的治疗效果较好,且完全栓塞的程度较高,且预后较为明显,为颅内动脉瘤预后治疗首选的治疗时机。Objective To analyze effects of different treatment opportunities for interventional operation on the complete embolization rate and prognosis effect of patients with intracranial aneurysms. Methods 100 patients with intracranial aneurysms in our hospital from May 2015 to December 2018 were selected. Patients were divided into early treatment group and late treatment group. All patients underwent treatment for intravascular embolization. The embolization, prognostic GCS score, modified Barthel index scale, and complication rate of the two groups were recorded. Results(1) In the early treatment group, 44 patients were completely embolized, 5 patients were mostly embolized, 1 patient was partially embolized, and the complete embolization rate was 88%. In the late treatment group, 25 patients were completely embolized, 13 patients were mostly embolized, 12 patients were partially embolized, and the complete embolization rate was 50%.(2) n the early treatment group, 2 patients had cerebral infarction, 2 patients had lower extremity venous thrombosis, 3 patients had hydrocephalus, 2 patients had rupture and rebleeding, and 5 patients had cerebral vasospasm. The incidence of complications was 28%. In the late treatment group, 8 patients had cerebral infarction, 6 patients had lower extremity venous thrombosis, 5 patients had hydrocephalus, 3 patients had rupture and rebleeding, and 10 patients had cerebral vasospasm. The incidence of complications was 64%.(3) The GCS score of the early treatment group was(13.2±1.8), and the Barthel index was(82.8±7.8). The GCS score of the advanced treatment group was(13.9±2.0), and the Barthel index was(70.5±5.5). Conclusion Early interventional therapy has a good curative effect on the patients, a relatively high degree of complete embolization and relatively obvious prognosis, which is the preferred time for the prognosis of intracranial aneurysms.

关 键 词：不同介入手术 治疗时机 颅内动脉瘤 完全栓塞率 预后效果 

分 类 号：R743.9[医药卫生—神经病学与精神病学]