介入栓塞与开颅夹闭术治疗颅内动脉瘤性蛛网膜下腔出血的效果及对认知功能影响的对比研究  

Comparative Study on the Efficacy and the Influence of Cognitive Function of Interventional Embolization and Craniotomy Clipping in the Treatment of Intracranial Aneurysmal Subarachnoid Hemorrhage

作　　者：刘永贵 LIU Yonggui(Dehongzhou People’s Hospital,Mangshi 678400,China)

机构地区：[1]云南省德宏州人民医院,云南芒市678400

出　　处：《中国医学创新》2021年第19期127-131,共5页Medical Innovation of China

摘　　要：目的:探讨介入栓塞与开颅夹闭术治疗颅内动脉瘤性蛛网膜下腔出血的效果及对认知功能的影响。方法:选择2015年2月-2019年2月本院收治的88例颅内动脉瘤性蛛网膜下腔出血患者,根据随机数字表法将其分为对照组和观察组,每组44例。对照组采用开颅夹闭术,观察组采用介入栓塞术。比较两组疗效、改良Rankin量表评分、改良Barthel指数、并发症发生情况、复发率和MMSE评分。结果:观察组良好率高于对照组,较好率与一般率均低于对照组,差异均有统计学意义(P<0.05)。术前,两组改良Rankin量表评分和改良Barthel指数比较,差异均无统计学意义(P>0.05);术后6个月,观察组改良Barthel指数为(89.58±1.26)分高于对照组的(76.34±2.57)分,差异有统计学意义(P<0.05);观察组改良Rankin量表评分为(1.02±0.27)分低于对照组的(1.98±0.65)分,差异有统计学意义(P<0.05)。观察组术后脑积水、蛛网膜下腔出血、动脉瘤性蛛网膜下腔出血、脑血管痉挛发生率及复发率均低于对照组,差异均有统计学意义(P<0.05)。术前,两组MMSE评分比较,差异无统计学意义(P>0.05);术后2周、2个月、1年,观察组MMSE评分均高于对照组,差异均有统计学意义(P<0.05)。结论:介入栓塞术治疗颅内动脉瘤性蛛网膜下腔出血效果较好,可改善认知功能和日常生活能力,降低并发症的发生率和复发率。Objective:To investigate the efficacy and the influence of cognitive function of interventional embolization and craniotomy clipping in the treatment of intracranial aneurysmal subarachnoid hemorrhage.Method:A total of 88 patients with intracranial aneurysmal subarachnoid hemorrhage admitted in our hospital from February 2015 to February 2019 were selected,and they were divided into control group and observation group according to randomized digital tables,44 cases in each group.The control group was treated with craniotomy clipping,while the observation group was treated with interventional embolization.The efficacy,modified Rankin scale score,modified Barthel index,incidence of complications,recurrence rate and MMSE scores were compared between two groups.Result:The good rate of the observation group was higher than that of the control group,better rate and general rate were lower than those of control group,and the differences were statistically significant(P<0.05).Before surgery,there were no significant differences in modified Rankin scale score and modified Barthel index between two groups(P>0.05);6 months after surgery,the modified Barthel index of observation group was(89.58±1.26)points higher than(76.34±2.57)points of control group,the difference was statistically significant(P<0.05).The modified Rankin scale score of observation group was(1.02±0.27)points lower than(1.98±0.65)points of control group,the difference was statistically significant(P<0.05).The incidences of postoperative hydrocephalus,subarachnoid hemorrhage,aneurysmal subarachnoid hemorrhage,cerebral vasospasm and recurrence rate of observation group were lower than those of control group,and the differences were statistically significant(P<0.05).Before surgery,there was no significant difference in MMSE score between two groups(P>0.05);2 weeks,2 months and 1 year after surgery,the MMSE scores of observation group were higher than those of control group,the differences were statistically significant(P<0.05).Conclusion:Interventional emb

关 键 词：颅内动脉瘤 蛛网膜下腔出血 开颅夹闭术 介入栓塞 

分 类 号：R651.12[医药卫生—外科学]