支架辅助弹簧圈栓塞术与单纯弹簧圈栓塞术治疗颅内破裂动脉瘤患者的效果比较及对术后出血事件的影响  

Comparison the effects of stent assisted coil embolization and simple coil embolization in the treatment of patients with ruptured intracranial aneurysms and the influence on postoperative bleeding events

作　　者：康平[1] 苏龙[1] 马改平[1] 马刘佳[1] 魏健强[1] 罗帅 李健[1] KANG Ping;SU Long;MA Gaiping;MA Liujia;WEI Jianqiang;LUO Shuai;LI Jian(Affiliated Hospital of Yan'an University,Yan'an 716000,China)

机构地区：[1]延安大学附属医院,陕西延安716000

出　　处：《临床医学研究与实践》2022年第2期12-15,69,共5页Clinical Research and Practice

基　　金：国家自然科学基金资助项目(No.81341112)。

摘　　要：目的比较支架辅助弹簧圈栓塞术与单纯弹簧圈栓塞术治疗颅内破裂动脉瘤患者的效果及对术后出血事件的影响。方法选取2019年3月至2021年3月来我院诊治的82例颅内破裂动脉瘤患者作为研究对象,按照电脑盲选法将其分为对照组和研究组,每组41例。对照组采用单纯弹簧圈栓塞术治疗,研究组采用支架辅助弹簧圈栓塞术治疗。分析两组患者的颅内压、脑脊液炎症因子水平、临床疗效、术后不良事件发生情况、复发率、免疫功能及氧化应激指标。结果术后3、5、7 d,研究组的颅内压明显低于对照组,差异具有统计学意义(P<0.05)。术后3 d,两组的白介素-8(IL-8)、白介素-4(IL-4)及肿瘤坏死因子-α(TNF-α)水平均升高,但研究组低于对照组,差异具有统计学意义(P<0.05)。研究组的治疗总有效率为95.12%(39/41),明显高于对照组的80.49%(33/41),差异具有统计学意义(P<0.05);两组的死亡率比较,差异无统计学意义(P>0.05)。研究组的出血事件发生率和复发率低于对照组,差异具有统计学意义(P<0.05);两组的残疾发生率比较,差异无统计学意义(P>0.05)。术后24 h,两组的CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)均升高,CD8^(+)均降低,且研究组优于对照组,差异具有统计学意义(P<0.05)。术后7 d,两组的丙二醛(MDA)水平均降低,超氧化物歧化酶(SOD)水平均升高,且研究组优于对照组,差异具有统计学意义(P<0.05)。结论支架辅助弹簧圈栓塞术应用于颅内破裂动脉瘤中的效果良好,对颅内压的降低及炎症反应的减轻具有促进作用,有利于减少不良事件的发生,改善患者的免疫功能与氧化应激反应。Objective To compare the effects of stent assisted coil embolization and simple coil embolization in the treatment of patients with ruptured intracranial aneurysms and the influence on postoperative bleeding events.Methods A total of 82 patients with ruptured intracranial aneurysms treated in our hospital from March 2019 to March 2021 were selected as the research objects.The patients were divided into control group and study group according to computer blind selection method,with 41 cases in each group.The control group was treated with simple coil embolization,and the study group was treated with stent assisted coil embolization.The intracranial pressure,cerebrospinal fluid inflammatory factor level,clinical efficacy,postoperative adverse events,recurrence rate,immune function and oxidative stress indexes of patients were analyzed between the two groups.Results At 3,5 and 7 d after operation,the intracranial pressure in the study group was significantly lower than that in the control group,and the differences were statistically significant(P<0.05).At 3 d after operation,the levels of interleukin-8(IL-8),interleukin-4(IL-4)and tumor necrosis factor-α(TNF-α)in the two groups increased,but those in the study group were lower than the control group,the differences were statistically significant(P<0.05).The total effective rate of treatment in the study group was 95.12%(39/41),which was significantly higher than 80.49%(33/41)in the control group,the difference was statistically significant(P<0.05);there was no significant difference in the mortality between the two groups(P>0.05).The incidence of bleeding events and recurrence rate in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05);there was no significant difference in the disability rate between the two groups(P>0.05).At 24 h after operation,the CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the two groups increased,but the CD8^(+)decreased,and those in the study group were better than the control group

关 键 词：颅内破裂动脉瘤 支架 弹簧圈栓塞术 术后出血事件 

分 类 号：R739.41[医药卫生—肿瘤]