早期血管内介入栓塞术对颅内动脉瘤破裂患者氧化应激反应及神经功能的影响  

Effect of early endovascular embolization on the oxidative stress response and neurological function in patients with ruptured intracranial aneurysm

作　　者：徐兵[1] 宣家龙[1] 雍成明[1] 杨代明[1] 黄录茂[1] 程志华 XU Bing;XUAN Jialong;YONG Chengming;YANG Daiming;HUANG Lumao;CHENG Zhihua(Department of Neurosurgery,Chaohu Hospital Affiliated to Anhui Medical University,Chaohu 238000,Anhui Province,China)

机构地区：[1]安徽医科大学附属巢湖医院神经外科,安徽巢湖238000

出　　处：《新乡医学院学报》2021年第4期357-360,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨早期血管内介入栓塞术对颅内动脉瘤破裂患者氧化应激反应及神经功能的影响。方法选择2016年1月至2020年5月安徽医科大学附属巢湖医院收治的58例颅内动脉瘤破裂患者为研究对象,所有患者行血管内介入栓塞术治疗,根据手术时机将患者分为观察组(n=30)和对照组(n=28),对照组患者于发病3 d后接受血管内介入栓塞术治疗,观察组患者于发病3 d内接受血管内介入栓塞术治疗。2组患者于术后第7天评估颅内动脉瘤栓塞情况;术前及术后第7天,采用美国国立卫生研究院卒中量表(NIHSS)评估患者神经功能缺损,采用改良Barthel指数(MBI)评估患者的日常生活活动能力,采用紫外分光光度法检测血清丙二醛(MDA)、超氧化物歧化酶(SOD)水平;观察2组患者并发症发生情况。结果观察组和对照组患者颅内动脉瘤完全栓塞率分别为73.33%(22/30)、39.29%(11/28),观察组患者颅内动脉瘤完全栓塞率显著高于对照组(Z=2.684,P<0.05)。2组患者术前NIHSS评分、MBI评分比较差异无统计学意义(P>0.05);与术前比较,2组患者术后第7天NIHSS评分显著降低,MBI评分显著升高(P<0.05);术后第7天,观察组患者NIHSS评分显著低于对照组,MBI评分显著高于对照组(P<0.05)。2组患者术前血清MDA、SOD水平比较差异无统计学意义(P>0.05);与术前比较,2组患者术后第7天血清MDA水平显著降低,SOD水平显著升高(P<0.05);术后第7天,观察组患者血清MDA水平显著低于对照组,SOD水平显著高于对照组(P<0.05)。观察组和对照组患者并发症发生率分别为3.33%(1/30)、25.00%(7/28),观察组患者并发症发生率显著低于对照组(χ2=5.718,P<0.05)。结论早期血管内介入栓塞术可有效减轻颅内动脉瘤破裂患者氧化应激反应、神经功能缺损,提高完全栓塞率,降低并发症发生率。Objective To investigate the effect of early endovascular embolization on the oxidative stress response and neurological function in patients with ruptured intracranial aneurysm.Methods Fifty-eight patients with ruptured intracranial aneurysms admitted to Chaohu Hospital Affiliated to Anhui Medical University from January 2016 to May 2020 were selected as the research subjects,all patients underwent endovascular embolization,and the patients were divided into observation group(n=30)and control group(n=28)according to the operative timing.The patients in the control group received intravascular embolization after three days of onset,while the patients in the observation group received intravascular embolization within three days of onset.The results of embolization of intracranial aneurysms were evaluated on the seventh day after operation in the two groups.Before operation and seven days after operation,the neurologic impairment of patients was evaluated by the National Institute of Health stroke scale(NIHSS),and the activities of daily living of patients were evaluated by modified Barthel index(MBI),and the levels of serum malondialdehyde(MDA)and superoxide dismutase(SOD)were detected by ultraviolet spectrophotometry.The complications of patients in the two groups were observed.Results The complete embolization rate of intracranial aneurysms in the observation group and the control group was 73.33%(22/30)and 39.29%(11/28),respectively.The complete embolization rate of intracranial aneurysms in the observation group was significantly higher than that in the control group(Z=2.684,P<0.05).There was no significant difference in the NIHSS score and MBI score between the two groups before operation(P>0.05).Compared with before operation,the NIHSS score was significantly decreased,and the MBI score was significantly increased in the two groups on the seventh day after operation(P<0.05).On the seventh day after operation,the NIHSS score in the observation group was significantly lower than that in the control group,and

关 键 词：颅内动脉瘤破裂 手术时机 血管内介入栓塞术 氧化应激反应 神经功能 

分 类 号：R743[医药卫生—神经病学与精神病学]