早期介入栓塞治疗颅内动脉瘤的效果及对患者神经功能精神状态和日常生活能力的影响  

The Curative Effect of Early Interventional Embolization on the Treatment of Intracranial Aneurysm and Its Effect on the Patients'Neurological Function Mental State and Activities of Daily Living

作　　者：李江涛[1] 杨华[1] 范玉军 LI Jiangtao;YANG Hua;FAN Yujun(The First People's Hospital of Guangyuan, Sichuan Guangyuan 628000,China)

机构地区：[1]四川省广元市第一人民医院介入科,四川广元628000

出　　处：《河北医学》2020年第8期1317-1321,共5页Hebei Medicine

基　　金：2016年四川省卫生和计划生育委员会科研课题,(编号:16PJ015)。

摘　　要：目的:探究早期介入栓塞应用于颅内动脉瘤的治疗疗效,并观察其对患者的神经功能、精神状态及日常生活能力的影响。方法:选取我院2016年3月至2019年3月收治的颅内动脉瘤患者(n=84例)为实验对象,以随机数字表法简单随机分组为对照组与观察组,其中对照组(n=42例)行晚期介入栓塞治疗,观察组(n=42例)行早期介入栓塞治疗。观察两组患者治疗后的临床疗效、并发症发生率、预后情况、治疗前后的神经功能评分(NIHSS)、日常生活能力评分(ADL)及精神状态评分(KPS)。结果:与对照组总有效率的71.43%相比,观察组的总有效率为95.24%,两组差异显著,具有统计学意义(χ^2=8.571,P<0.05)。与对照组病死率的14.29%、致残率的23.81%相比,观察组的病死率为2.38%、致残率为4.76%,两组差异显著,具有统计学意义(P<0.05)。重复测量方差分析结果显示,不同组别不同时点患者的NHISS评分、KPS评分、ADL评分、MMSE评分的主体内效应及主体间效应比较,差异具有统计学意义(P<0.05)。观察组患者的NHISS评分为(14.50±1.81)分,显著低于对照组[(20.19±4.24)分,P<0.05];KPS评分为(86.05±6.84)分,显著高于对照组[(78.36±7.58)分,P<0.05];ADL评分为(78.45±7.62)分,显著高于对照组[(61.57±8.06)分,P<0.05];MMSE评分为(26.52±4.17)分,显著高于对照组[(19.86±4.71)分,P<0.05]。与对照组总并发症的26.19%相比,观察组的总并发症发生率为7.14%,两组差异显著,具有统计学意义(χ^2=5.486,P<0.05)。结论:与晚期介入栓塞相比,早期介入栓塞应用于颅内动脉瘤中具有更理想的疗效,可显著改善患者的神经状态、提高日常生活能力、恢复神经功能,有效减少并发症,患者预后效果良好。Objective:To explore the therapeutic effect of early interventional embolization in the treatment of intracranial aneurysms,and to observe the effects of early interventional embolization on the neurological function,mental state and activities of daily living of the patients.Methods:The patients with intracranial aneurysm(n=84)from March 2016 to March 2019 were selected as experimental subjects,and divided into two groups with the random digital table method.The control group(n=42)was treated with advanced interventional embolization,and the observation group(n=42)was treated with early intervention.The clinical effect,complication rate,prognosis,neurological function score(NIHSS),daily life ability score(ADL)and mental state score(KPS)were observed before and after treatment.Results:The total effective rate of the observation group was 95.24%in comparison with 71.43%of the total effective rate of the control group(χ^2=8.571,P<0.05).Compared with 14.29%of the mortality rate and 23.81%of the disability rate in the control group,the mortality rate in the observation group was 2.38%and the disability rate was 4.76%The difference between the two groups was obvious and statistically significant(P<0.05).The results of repeated ANOVA showed that the NHISS score,KPS score,ADL score,intra-subject effect and inter-subject effect of different time points were statistically significant(P<0.05).The NHISS score of the patients in the observation group was(14.50±1.81),which was significantly lower than that in the control group[(20.19±4.24),P<0.05].The scores of KPS(86.05±6.84)were higher than that in the control group[(78.36±7.58),P<0.05].The score of ADL(78.45±7.62)was significantly higher than that in the control group[(61.57±8.06),P<0.05],and the MMSE score(26.52±4.17)was significantly higher than that in the control group[(19.86±4.71),P<0.05].Compared with 26.19%of the total complications in the control group,the total incidence of complications in the observation group was 7.14%.There was significant difference

关 键 词：早期介入栓塞 颅内动脉瘤 神经功能 精神状态 日常生活能力 

分 类 号：R47[医药卫生—护理学]