介入栓塞术治疗颅内动脉瘤的疗效及对血管内皮功能的影响  

Interventional embolization in the surgical treatment of intracranial aneurysms and its effect on vascular endothelial function

作　　者：茹睿 崔萍[1] 宗余余 王玉[1] RU Rui;CUI Ping;ZONG Yuyu;WANG Yu(Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院,河南南阳473000

出　　处：《中国实用神经疾病杂志》2022年第12期1495-1500,共6页Chinese Journal of Practical Nervous Diseases

基　　金：河南省科技发展计划项目(编号:192102310349)。

摘　　要：目的探讨栓塞介入术治疗颅内动脉瘤的临床疗效,以及对血管内皮功能的影响。方法选择南阳市中心医院2017-03—2020-02收治疗的颅内动脉瘤手术患者156例为研究对象,对照组(n=78)采用开颅夹闭术,观察组(n=78)采用介入栓塞术,术后2周对治疗效果进行评估;随访3个月,比较2组炎性因子、血管内皮功能、神经缺损评分、并发症及预后。结果观察组治疗后2周CGRP水平高于对照组[(56.73±6.81)pg/mL比(47.09±6.15)pg/mL,P<0.05],ET-1、VEGF、IL-8及TNF-α水平均低于对照组[(72.53±8.45)pg/mL、(122.13±10.53)ng/mL、(1.43±0.25)ng/mL、(0.23±0.08)ng/mL比(102.69±13.26)pg/mL、(185.67±12.36)ng/mL、(2.41±0.49)ng/mL、(0.37±0.09)ng/mL,P<0.05]。术后2周与对照组比较,观察组NIHSS评分显著降低[(7.46±0.85)分比(19.23±1.13)分,P<0.05],BI评分显著升高[(84.14±7.31)分比(79.58±6.32)分,P<0.05]。2组术后其他方面比较差异无统计意义(P>0.05)。观察组术后3个月死亡、植物生存及残疾率低于术前(P<0.05)。结论介入栓塞术治疗颅内动脉瘤患者,能降低炎症因子水平,改善患者血管内皮功能,减轻神经缺损评分,术后并发症发生风险明显降低,预后较佳。Objective To investigate the effect of interventional embolization in the surgical treatment ofintracranial aneurysms and its influence on vascular endothelial function.Methods A total of 156 patientsundergoing intracranial aneurysm surgery in our hospital from March 2017 to February 2020 were selected assubjects,and they were divided into two groups by lottery,78 cases in each group.The control group was treatedwith craniotomy and clipping,and the observation group was treated with interventional embolization forintracranial aneurysms.The patient’s effect was evaluated 2 weeks after the operation,and a 3-month follow-upwas completed.The inflammatory factors and vascular endothelium function,nerve defect score,complications andprognosis of two groups were compared.Results Two weeks after treatment,compared with the control group,theCGRP level and a BI score in the observation group increased significantly(P<0.05);the levels of et-1,VEGF,IL-8,TNF-αwere and NIHSS score significantly decreased(P<0.05);the incidence of postoperative rebleeding,lung infection,and hydrocephalus in the two groups was not statistically significant(P>0.05).The mortality,plant survival and disability rates in the observation group were lower than those before surgery at 3 months aftersurgery(P<0.05).Conclusion Interventional embolization for intracranial aneurysm surgery can reduce thelevel of inflammatory factors,improve the patient’s vascular endothelial function,reduce nerve defect scores,anddoes not increase the incidence of postoperative complications.It can obtain a good prognosis for treatment.

关 键 词：颅内动脉瘤 介入栓塞术 血管内皮功能 开颅夹闭术 炎症因子 

分 类 号：R743[医药卫生—神经病学与精神病学]