基于弹簧圈瘤腔内栓塞术探讨急诊蛛网膜下腔出血的疗效及体液免疫指标表达水平变化分析  

Study on therapeutic effect of emergency subarachnoid hemorrhage and expression of humoral immune indexes based on coil tumor endovascular embolization

作　　者：易明亮[1] 王波元 周波 雷春宇 虞德明[1] YI Ming-liang;WANG Bo-yuan;ZHOU Bo(Department of Neurosurgery,the Third People s Hospital of Yibin,644000 Yibin,China)

机构地区：[1]宜宾市第三人民医院神经外科,宜宾644000 [2]叙州区人民医院神经外科

出　　处：《临床神经外科杂志》2022年第5期583-586,共4页Journal of Clinical Neurosurgery

基　　金：中国卒中学会脑血管病全程管理项目启航基金。

摘　　要：目的 研究弹簧圈瘤腔内栓塞术治疗急诊蛛网膜下腔出血的疗效及对其体液免疫指标水平的影响。方法 纳入2017年10月—2020年8月宜宾市第三人民医院诊疗的高分级动脉瘤蛛网膜下腔出血患者102例,按照随机数字表法分为观察者(n=82例)和对照组(n=40例)。观察组给予弹簧圈瘤腔内术,对照组给予动脉瘤颈夹闭术。对两组进行3个月随访,比较两组患者的疗效、GOS评分、神经功能、睡眠质量、免疫指标[免疫球蛋白(Ig) A、Ig M及Ig G]水平、住院时间、复发率、完全闭塞率及并发症发生率(颅内感染、脑血管痉挛、再出血及脑积水)。结果 观察组患者预后良好率(76. 83%)高于对照组(42. 50%);治疗前,两组患者GOS评分、神经功能评分及睡眠质量评分无差异(P> 0. 05)。治疗后,观察组GOS评分、神经功能评分及睡眠质量评分均低于对照组。手术前,两组患者Ig A、Ig M及Ig G水平无差异(P> 0. 05)。手术后两组患者免疫指标均先降低再升高,变化差异存在统计学意义,手术后1 d及手术后5 d,观察组Ig A、Ig M及Ig G水平均高于对照组;观察组住院时间明显短于对照组;两组患者复发率及完全闭塞率比较无统计学差异(P> 0. 05);观察组患者脑血管痉挛率均低于对照组(P=0. 025)。两组患者颅内感染率脑积水率及再出血率无差异(P>0. 05)。结论 弹簧圈瘤腔内栓塞术治疗急诊蛛网膜下腔出血具有良好的疗效,可改善患者神经功能及免疫功能,且并发症发生率低。Objective To study the effect of spring coil tumor embolization in the treatment of emergency subarachnoid hemorrhage(SAH)and its influenc on the index level of humoral immune.Methods A total of 112 patients with SAH in high-grade aneurysms treated in the Third People s Hospital of Yibin from October 2017 to August 2020 were selected,and divided into observers group(n=40)and control groups(n=82)according to randomized digital tables.The observation group gave the spring coil aneurysm and the control group.Both groups were followed up for 3 months to compare the efficacy of the two groups.GOS scores,neurological function,and sleep quality were compared between the two groups.Immunological measures[immunoglobulin(Ig)A,IgM,and IgG]levels were compared between the two patient groups.The duration of hospitalization,recurrence rate,complete occlusion rate,and complication incidence(intracranial infection,cerebral vasospasm,rehemorrhage,and hydrocephalus)were compared between the two groups.Results The good prognosis rate of patients in the observed group(76.83%)was significantly higher than in the control group(42.50%).There were no differences in GOS scores,neurological scores,and sleep quality scores between the two groups before treatment(P>0.05).Post-treatment,GOS,neural function and sleep quality scores were lower than control.Prior to surgery,the levels of IgA,IgM and IgG were not different between the two groups(P>0.05).After operation,the immune indexes of the two groups decreased first and then increased,and the difference was statistically significant,one day and 5 days after surgery,both the observed groups had higher IgA,IgM and IgG levels than in the control group.The length of hospital stay in the observation group was significantly shorter than that in the control group.There was no statistical difference in the recurrence rate and the complete occlusion rate between the two groups(P>0.05).The cerebral vasospasm rate in the observed group was lower than that in the control group(P=0.025).There were no di

关 键 词：弹簧圈瘤腔内栓塞术 蛛网膜下腔出血 疗效 体液免疫 

分 类 号：R651[医药卫生—外科学]