介入栓塞术对脑动脉瘤患者神经功能和内皮功能的影响  

Eeffect of interventional embolization on neural function and endothelial function in patients with cerebral aneurysms

作　　者：徐忠海[1] 许斌[2] 代全德[1] Xu Zhonghai;Xu Bin;Dai Quande(The First People’s Hospital of Shangqiu City,Shangqiu Clinical College of Xuzhou Medical University,Shangqiu 476000,China;Center of Neurointerventional Therapy,Henan Provincial People’s Hospital,Zhenzhou 450000,China)

机构地区：[1]商丘市第一人民医院徐州医科大学商丘临床学院神经介入科,商丘476100 [2]河南省人民医院神经介入治疗中心,郑州450000

出　　处：《中华实验外科杂志》2023年第6期1152-1155,共4页Chinese Journal of Experimental Surgery

摘　　要：目的:探讨介入栓塞术对脑动脉瘤患者神经功能和内皮功能的影响。方法:2018年1月至2021年1月我院治疗的脑动脉瘤患者作为研究对象,按照接受手术的方式分为夹闭组(102例)和介入组(102例),夹闭组患者采用显微镜夹闭术,观察组患者采用血管内介入栓塞术。治疗后,分析两组患者手术情况,临床治疗效果和并发症发生情况;采用美国国立卫生研究院卒中量表(NIHSS)评估患者神经功能缺损;采用Rankin量表分析患者独立生活能力情况;采用酶联免疫吸附试验(ELISA)或比色法检测血管假性血友病因子(vWF)、内皮素-1(ET-1)和一氧化氮(NO)的水平。计量数据比较采用t检验。结果:夹闭组患者手术时间[(89.22±10.03)min]低于介入组患者[(74.41±10.81)min],差异有统计学意义(t=8.079,P<0.05)。夹闭组患者出血量和住院时间[(157.22±15.03)ml和(14.16±1.82)d]高于介入组患者[(117.61±11.81)ml和(11.01±1.91)d],差异有统计学意义(t=20.930、17.050,P<0.05)。夹闭组患者治愈率68.63%(70/102)明显低于介入组患者[83.33%(85/102)],差异有统计学意义(χ^(2)=6.541,P<0.05)。夹闭组患者瘫痪率21.57%(22/102)和死亡率9.80%(10/102)明显高于介入组患者瘫痪率14.71%(15/102)和死亡率1.96%(2/102),差异有统计学意义(χ^(2)=4.123、2.947,P<0.05)。夹闭组患者术后部分栓塞发生率[10.78%(11/102)]明显高于对照组[1.96%(2/102)],差异有统计学意义(χ^(2)=5.124,P<0.05)。观察组患者术后脑积水发生率[3.92%(4/102)]明显低于对照组[15.68%(16/102)],差异有统计学意义(χ^(2)=3.458,P<0.05)。夹闭组患者治疗后NIHSS评分[(31.44±3.01)分]明显高介入组患者NIHSS评分[(23.2±2.36)分],差异有统计学意义(t=20.930,P<0.05)。夹闭组患者治疗后Rankin评分[(3.03±0.48)分]明显高介入组患者Rankin评分[(2.44±0.42)分],差异有统计学意义(t=9.210,P<0.05)。夹闭组患者治疗后vWF和ET-1水平[(112.00±9.83)ng/ml、(72.38±9.46)pg/ml]明显高于�Objective To investigate the effects of interventional embolization on the neural function and endothelial function in patients with cerebral aneurysms.Methods Retrospective analysis was made on the patients with cerebral aneurysms treated in our hospital from January 2018 to January 2021.They were divided into the clipping group(102 cases)and the interventional group(102 cases)according to the way of operation.The patients in the clipping group were treated with microscopic clipping,and those in the observation group were treated with intravascular interventional embolization.After treatment,the surgical conditions,clinical treatment effects and complications of the two groups were analyzed.The national institutes of health stroke scale(NIHSS)was used to assess the neurological deficit of patients.Rankin scale was used to analyze the independent living ability of patients.The levels of von willebrand factor(vWF),endothelin-1(ET-1)and nitric oxide(NO)were detected by enzyme linked immunosorbent assay(ELISA)or colorimetry.The measurement data were compared by t-test.Results The operation time in the clipping group[(89.22±10.03)min]was shorter than that in the interventional group[(74.41±10.81)min,t=8.079,P<0.05].The amount of bleeding and hospitalization time[(157.22±15.03)ml and(14.16±1.82)d]in the clamping group increased as compared with those in the interventional group[(117.61±11.81)ml and(11.01±1.91)d,t=20.930,17.050,P<0.05].The cure rate of patients in the clipping group was 68.63%(70/102),which was significantly lower than that in the interventional group[83.33%(85/102),χ^(2)=6.541,P<0.05].The paralysis rate of 21.57%(22/102)and mortality rate of 9.80%(10/102)in the clipping group were significantly higher than those of 14.71%(15/102)and 1.96%(2/102)in the interventional group(χ^(2)=4.123,2.947,P<0.05).The incidence of partial embolism in the clipping group[10.78%(11/102)]was significantly higher than that in the control group[1.96%(2/102),χ^(2)=5.124,P<0.05].The incidence of postoperative hydroce

关 键 词：介入栓塞术 脑动脉瘤 神经功能 内皮功能 并发症 

分 类 号：R651.12[医药卫生—外科学]