双微导管联合弹簧圈填塞治疗对颅内动脉瘤患者认知功能、炎性因子及预后的影响  

Effects of Double Microcatheter Combined with Coil Embolization on Cognitive Function,Inflammatory Cytokines and Prognoses of Patients with Intracranial Aneurysm

作　　者：田秋思 梁彦彬 王克[1] 包志军[1] 黄伟 TIAN Qiu-si;LIANG Yan-bin;WANG Ke;BAO Zhi-jun;HUANG Wei(Department of Neurosurgery,the 3201 Hospital Affiliated to Medical College of Xi'an Jiaotong University,Hanzhong,Shaanxi 723000,China)

机构地区：[1]西安交通大学医学院附属三二〇一医院神经外科,陕西汉中723000

出　　处：《解放军医药杂志》2021年第5期79-83,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：陕西省卫生健康科研基金项目(2018C003)。

摘　　要：目的分析双微导管联合弹簧圈填塞治疗对颅内动脉瘤(IA)患者认知功能、炎性因子及预后的影响。方法选取2017年7月—2019年7月本院收治的85例IA患者,据手术方式的不同分为研究组45例(予双微导管联合弹簧圈填塞治疗)和对照组40例(予开颅夹闭术治疗)。对比2组手术指标(手术时长、住院时间),术前及术后24 h血流动力学指标[收缩压(SBP)、舒张压(DBP)、心率(HR)、每搏心输出量(SV)、心输出量(CO)及心排血指数(CI)],术后7 d认知功能[简易智能精神状态检查量表(MMSE)评分],术前及术后7 d炎性因子[血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、转化生长因子-β(TGF-β)]水平,预后情况[改良Rankin量表(mRS)评分和日常生活活动能力(ADL)量表评分]及术后并发症发生情况。结果研究组手术时长、住院时间均短于对照组(P<0.01)。术后24 h,2组SBP、DBP、HR及SV水平均升高,CO、CI水平均降低,且研究组SBP、DBP、HR及SV水平较对照组高,CO、CI水平较对照组低,差异均有统计学意义(P<0.05或P<0.01)。研究组术后7 d MMSE量表各方面评分均高于对照组(P<0.01)。术后7 d,2组TNF-α、IL-6、TGF-β水平均显著下降,且研究组低于对照组,差异均有统计学意义(P<0.05或P<0.01)。研究组术后6个月mRS评分低于对照组,ADL量表评分高于对照组,差异有统计学意义(P<0.01)。2组术后并发症发生率比较差异无统计学意义(P>0.05)。结论双微导管联合弹簧圈填塞治疗可显著降低IA患者体内炎性因子水平,改善患者认知功能、血流动力学指标及预后,且安全性高。Objective To analyze effects of double microcatheter combined with coil embolization on cognitive function,inflammatory cytokines and prognoses of patients with intracranial aneurysm(IA).Methods A total of 85 IA patients admitted during July 2017 and July 2019 were selected and divided into research group(treated with double microcatheter combined with coil embolization,n=45)and control group(treated with craniotomy and clamp,n=40)according to different operation methods.Surgical indicators(duration of operation and length of hospital stay),hemodynamic indicators before and at the 24 th h after operation[systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),stroke volume(SV),cardiac output(CO)and cardiac index(CI)],conditions of cognitive function[Mini-Mental State Examination(MMSE)score]at the 7 th d after operation,levels of inflammatory cytokines[serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and transforming growth factor-β(TGF-β)]before and at the 7 th d after operation,prognosis conditions[modified Rankin Scale(MRS)score and ability of daily living(ADL)scale score]and postoperative conditions of complications were compared between two groups.Results Duration of operation and length of hospital stay were significantly shorter in research group than those in control group(P<0.01).At the 24 th h after operation,levels of SBP,DBP,HR and SV were significantly increased,while levels of CO and CI were significantly decreased in two groups;in research group,levels of SBP,DBP,HR and SV were higher,while levels of CO and CI were lower than those in control group(P<0.05 or P<0.01).All scores of MMSE scale score in research group were significantly higher than those in control group at the 7 th after operation(P<0.01).At the 7 th d after operation,levels of TNF-α,IL-6 and TGF-βwere significantly decreased in two groups,and the levels in research group were significantly lower than those in control group(P<0.05 or P<0.01).In research group,mRS score was significantly lower than that in

关 键 词：颅内动脉瘤 双微导管 弹簧圈填塞 简易智能精神状态检查量表 肿瘤坏死因子α 日常生活活动量表 手术后并发症 

分 类 号：R651.12[医药卫生—外科学]