开颅夹闭术治疗颅内动脉瘤的效果观察及对血流动力学、神经元特异烯醇化酶和S100B蛋白表达影响研究  

Effect of transcranial clipping in the treatment of intracranial aneurysms and its influence on hemodynamics,NSE and S100B expression

作　　者：柴海飞[1] 郭小琴[2] 钱卫央[1] 胡小铭[1] 汪杰[1] Chai Haifei;Guo Xiaoqin;Qian Weiyang;Hu Xiaoming;Wang Jie(Department of Neurosurgery,Taizhou Hospital,Taizhou,Zhejiang 317000,China;Department of Anesthesiology,Taizhou Hospital,Taizhou,Zhejiang 317000,China)

机构地区：[1]浙江省台州医院神经外科,317000 [2]浙江省台州医院麻醉科,317000

出　　处：《中国基层医药》2020年第23期2873-2876,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的:探讨开颅夹闭术治疗颅内动脉瘤的效果及对血流动力学、神经元特异烯醇化酶(NSE)和S100B蛋白表达的影响。方法:回顾性分析浙江省台州医院2017年1月至2019年6月收治的颅内动脉瘤患者47例的临床资料,均行动脉瘤开颅夹闭术治疗,观察术中和术后指标变化;比较术前和术后1周血流动力学、NSE和S100B水平变化;所有研究对象随访6个月评价预后情况。结果:所有研究对象完成手术,手术时间(2.79±0.43)h,术中出血量(243.51±28.73)mL,术后并发症发生率6.38%(3/47),住院时间(16.74±1.86)d。术后1周,脑血容量(27.98±3.24)mL/100 g,脑血流量(2.08±0.34)mL·100 g-1·min-1,均高于术前的(23.41±2.36)mL/100 g和(1.56±0.27)mL·100 g-1·min-1(t=7.816、8.211,均P<0.05)。术后1周,血清NSE(15.28±2.18)μg/L,S100B(0.83±0.16)μg/L,均低于术前的(26.39±4.25)μg/L和(1.59±0.27)μg/L(t=15.946、16.601,均P<0.05)。随访6个月,预后良好38例,占80.85%。结论:开颅夹闭术治疗颅内动脉瘤的效果明显,且可改善血流动力学,降低血清NSE和S100B表达,并发症少。Objective To investigate the effect of transcranial clipping in the treatment of intracranial aneurysms and its influence on hemodynamics,neuron specific enolase(NSE)and S100B expression.Methods A retrospective analysis was made in 47 patients with intracranial aneurysms who admitted to Taizhou Hospital of Zhejiang Province from January 2017 to June 2019,all patients were treated by transcranial clipping.The hemodynamics,NSE and S100B levels were compared before operation and 1 week after operation.All patients were followed up for 6 months to evaluate the prognosis.Results All patients completed the operation,the operation time was(2.79±0.43)h,the intraoperative bleeding volume was(243.51±28.73)mL,the incidence of postoperative complications was 6.38%(3/47),and the average hospitalization time was(16.74±1.86)d.One week after operation,the cerebral blood volume[(27.98±3.24)mL/100g]and cerebral blood flow[(2.08±0.34)mL·100g-1·min-1]were higher than those before operation[(23.41±2.36)mL/100g and(1.56±0.27)mL·100g-1·min-1](t=7.816,8.211,all P<0.05).The serum NSE[(15.28±2.18)μg/L]and S100B[(0.83±0.16)μg/L]were lower than those before operation[(26.39±4.25)μg/L and(1.59±0.27)μg/L](t=15.946,16.601,all P<0.05).After follow-up for 6 months,38 cases(80.85%)had a good prognosis.Conclusion Transcranial clipping is effective in the treatment of intracranial aneurysms,and can improve hemodynamics,reduce the expression of NSE and S100B in serum,and reduce complications.

关 键 词：颅内动脉瘤 动脉瘤开颅夹闭 术后并发症 血流动力学 脑血容量 脑血流量 神经元特异烯醇化酶 S100B蛋白 

分 类 号：R651.12[医药卫生—外科学]