翼点入路显微镜下颅内动脉瘤夹闭术治疗前循环颅内动脉瘤患者成本-效果评价  

Cost-effectiveness evaluation of intracranial aneurysm clipping under pterional approach microscope in treatment of patients with anterior circulation intracranial aneurysms

作　　者：张永斌[1] 吴涛 高强[3] ZHANG Yongbin;WU Tao;GAO Qiang(Department of Neurosurgery,Baoji Hospital of Traditional Chinese Medicine,Baoji 721001,China)

机构地区：[1]宝鸡市中医医院神经外科,陕西宝鸡721001 [2]西安市红会医院神经外科,陕西西安710054 [3]宝鸡市人民医院神经外科,陕西宝鸡721000

出　　处：《陕西医学杂志》2022年第11期1355-1359,共5页Shaanxi Medical Journal

基　　金：陕西省重点研发计划项目(2018SF-2N3)。

摘　　要：目的:探讨前循环颅内动脉瘤患者以翼点入路行显微镜下颅内动脉瘤夹闭术的成本-效果。方法:78例前循环颅内动脉瘤患者,依据随机数字表法将其分为观察组和对照组,各39例。对照组接受血管介入动脉栓塞术,观察组接受翼点入路显微镜下颅内动脉瘤夹闭术,两组均于术后持续随访12个月。比较两组手术相关指标、术前及术后1个月生活质量及血清神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)、星形胶质源性蛋白(S100B)水平、术后12个月神经功能、术后1个月内并发症发生情况。结果:观察组手术时间、术后总住院时间长于对照组,术中出血量多于对照组,住院总费用低于对照组(均P<0.05);与术前相比,术后1个月两组生活质量各项评分均升高(均P<0.05),但两组间经比较差异无统计学意义(P>0.05);术后12个月,观察组神经功能优良率高于对照组(P<0.05);与术前相比,术后1个月两组血清NSE、MBP、S100B水平均降低,观察组低于对照组(均P<0.05);术后1个月两组并发症总发生率比较差异无统计学意义(P>0.05)。结论:以翼点入路行显微镜下颅内动脉瘤夹闭术治疗前循环颅内动脉瘤能有效减少颅内动脉瘤对脑组织形成的继发性损伤,促进患者神经功能恢复,提升整体生活质量,在降低治疗成本的同时效果更佳。Objective:To study the cost-effectiveness of microscopic intracranial aneurysm clipping under the pterional approach microscope in the treatment of patients with anterior circulation intracranial aneurysms.Methods:A total of 78 subjects with anterior circulation intracranial aneurysms were divided into observation group and control group according to the random number table method,with 39 cases in each.The control group received vascular interventional arterial embolization,and the observation group received intracranial aneurysm clipping under the pterional approach microscope.Both groups were followed up for 12 months after operation.The operation-related indicators,quality of life,serum NSE,MBP,S100 B levels before operation and 1 month after operation,neurological function at 12 months after operation,and the incidence of complications within 1 month after operation were compared between the two groups.Results:The operation time and postoperative total hospital stay in the observation group were longer than those in the control group,the intraoperative blood loss was more than that in the control group,and the total hospitalization expenses were lower than those in the control group(all P<0.05).Compared with preoperative,the quality of life scores in both groups increased at 1 month after operation(all P<0.05),but there was no significant difference between the two groups(P>0.05).At 12 months after operation,the excellent and good rate of neurological function in the observation group was higher than that in the control group(P<0.05).Compared with preoperative,the levels of serum NSE,MBP and S100 B in the two groups decreased at 1 month after operation,and the observation group was lower than the control group(all P<0.05).Within 1 month after operation,there was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion:Intracranial aneurysm clipping under the pterional approach microscope in the treatment of patients with anterior circulation intracranial aneu

关 键 词：前循环颅内动脉瘤 血管介入动脉栓塞术 翼点入路 显微镜下颅内动脉瘤夹闭术 生活质量 神经功能 

分 类 号：R739.41[医药卫生—肿瘤]