血小板聚集率检测在颅内动脉瘤介入治疗中的价值  

Value of platelet aggregation rate detection in interventional treatment for patients with unruptured intracranial aneurysms

作　　者：张翔宇 马义辉 张庭保 李正伟[1] 陈劲草[1] ZHANG Xiang-yu;MA Yi-hui;ZHANG Ting-bao;LI Zheng-wei;CHEN Jin-cao(Department of Neurosurgery,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院神经外科,武汉430071

出　　处：《中国临床神经外科杂志》2023年第1期1-4,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨血小板聚集率检测在颅内未破裂动脉瘤介入治疗中的价值。方法回顾性分析2020年1月至2022年4月使用支架辅助栓塞治疗的215例颅内未破裂动脉瘤的临床资料。术前1 d检测血小板聚集率,术后复查CT、MRI评估出血性和缺血性并发症。结果术后发生缺血性并发症16例(7.4%),出血性并发症14例(6.5%)。术前血小板聚集率≤15%的病人出血性并发症发生率(11.8%)较血小板聚集率>15%的病人(3.1%)明显增高(P<0.05)。而血小板聚集率与缺血性并发症无明显关系(P>0.05)。结论抗血小板药物的使用降低了支架辅助栓塞颅内动脉瘤病人的缺血风险,并且使术前血小板聚集率维持在较低水平,而术前血小板聚集率过低可能是发生出血性并发症的危险因素。当血小板聚集率≤15%时,需警惕出血风险。Objective To investigate the value of platelet aggregation rate detection in interventional treatment foRpatients with unruptured intracranial aneurysms.Methods The clinical data of 215 patients with unruptured intracranial aneurysms treated with stentassisted embolization from January 2020 to April 2022 were retrospectively analyzed.The platelet aggregation rate was detected 1 day before surgery.CT oRMRI was used to evaluate hemorrhagic and ischemic complications afteRthe surgery.Results Ischemic complications occurred in 16 patients(7.4%)and hemorrhagic complications in 14 patients(6.5%).The incidence of hemorrhagic complications in patients with platelet aggregation rate≤15%(11.8%)was significantly higheRthan that(3.1%)in patients with platelet aggregation rate>15%(P<0.05).There was no significant relationship between platelet aggregation rate and ischemic complications(P>0.05).Conclusions Antiplatelet drugs can maintain the preoperative platelet aggregation rate at a low level and reduce the risk of ischemic complications in patients with unruptured intracranial aneurysms afteRstent-assisted embolization.However,a low preoperative platelet aggregation rate may be a risk factoRfoRhemorrhagic complications.The platelet aggregation rate≤15%is a warning value foRthe bleeding.

关 键 词：颅内动脉瘤 未破裂动脉瘤 支架辅助栓塞 出血性并发症 缺血性并发症 血小板聚集率 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R815.2[医药卫生—临床医学]