血管内介入栓塞术结合高压氧治疗颅内动脉瘤及术后并发脑血管痉挛的因素分析  

Treatment of intracranial aneurysm with endovascular embolization combined with HBO and analysis of influencing factors of postoperative cerebral vasospasm

作　　者：王育胜[1] 洪映标[1] 蔡洁波[1] 彭晖[1] 陈泽鑫[1] 蔡跃豪[1] WANG Yusheng;HONG Yingbiao;CAI Jiebo;PENG Hui;CHEN Zexin;CAI Yuehao(Department of Neurosurgery,Jieyang People′s Hospital,Jieyang 522000,China)

机构地区：[1]揭阳市人民医院神经外三科,广东揭阳522000

出　　处：《沈阳医学院学报》2021年第1期22-24,28,共4页Journal of Shenyang Medical College

摘　　要：目的:探讨血管内介入栓塞术结合高压氧(HBO)治疗颅内动脉瘤的疗效,并对术后并发脑血管痉挛(CVS)的影响因素进行分析。方法:选取本院2015年5月至2020年5月收治的82例颅内动脉瘤患者为研究对象,采用随机数字表法分为对照组与研究组,各41例。对照组予以血管内介入栓塞术治疗,研究组予以血管内介入栓塞术结合HBO治疗,HBO治疗每次30 min,每天1次,10 d为一个疗程,共治疗2个疗程。比较2组的治疗效果、GCS评分及CVS发生率,采用多因素分析患者术后并发CVS的因素。结果:研究组的治疗总有效率、GCS评分明显高于对照组,而CVS发生率明显低于对照组(P<0.05)。Logistic回归分析显示CVS发生的危险因素为年龄(OR=2.776,95%CI:1.379~5.589)、Fisher分级(OR=2.765,95%CI:1.454~5.259)、蛛网膜下腔出血次数(OR=3.022,95%CI:1.519~6.013)。结论:血管内介入栓塞术联合HBO治疗颅内动脉瘤患者的疗效较好,可改善患者的意识障碍,在介入术前对合并CVS的危险因素进行分析,以采取措施避免患者术后并发CVS。Objective: To explore the efficacy of endovascular embolization combined with hyperbaric oxygen( HBO) in the treatment of patients with intracranial aneurysm,and analyze the influencing factors of postoperative cerebral vasospasm( CVS).Methods: A total of 82 patients with intracranial aneurysm admitted in our hospital from May 2015 to May 2020 were selected and were divided into two groups by random number table method,41 patients in each group. The control group received endovascular embolization,and the study group received endovascular embolization combined with HBO treatment. The HBO treatment was once a day for 30 minutes,and 10 days was a course of treatment,with a total of 2 courses of treatment. Multivariable analysis was used to analyze the influencing factors of postoperative CVS. Results: The total therapeutic efficiency and GCS score in the study group were significantly higher than those in the control group,while the incidence of CVS was significantly lower than that in the control group( P<0. 05). Logistic regression analysis showed that the risk factors of CVS were age( OR = 2. 776,95% CI: 1. 379-5. 589),Fisher grade( OR = 2. 765,95% CI: 1. 454-5. 259),and number of subarachnoid hemorrhage( OR = 3. 022,95% CI: 1. 519-6. 013). Conclusions: Endovascular embolization combined with HBO is effective in the treatment of patients with intracranial aneurysm. It can improve patients’ unconsciousness. Before intervention,the influencing factors of CVS should be analyzed to take measures to avoid postoperative CVS.

关 键 词：血管内介入栓塞术 高压氧 颅内动脉瘤 脑血管痉挛 影响因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]