早期显微手术夹闭与血管内介入治疗颅内动脉瘤破裂出血的效果比较  

Comparison of therapeutic effect of early microsurgical clipping versus endovascular intervention on hemorrhage caused by rupture of intracranial aneurysm

作　　者：刘政博 李帅[1] 孙岩 岳新灿[1] Liu Zhengbo;Li Shuai;Sun Yan;Yue Xincan(Neurological Intensive Care Unit,Zhoukou Central Hospital,Zhoukou 466000,China)

机构地区：[1]周口市中心医院神经重症监护室,周口466000

出　　处：《中国实用医刊》2023年第16期17-20,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较早期显微手术夹闭与血管内介入治疗颅内动脉瘤破裂出血的效果。方法抽取2021年2月至2023年2月周口市中心医院收治的颅内动脉瘤破裂出血患者78例,收集其临床资料并进行回顾性分析,将其中采用早期显微夹闭治疗的39例患者作为对照组,采用血管内介入治疗的39例患者作为观察组。统计并比较两组手术情况、美国国立卫生院卒中量表(NIHSS)评分、Barthel指数(BI)、格拉斯哥预后量表(GOS)分级、炎症反应指标[白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)]水平及并发症发生率。结果观察组手术时间短于对照组,术中出血量少于对照组(P<0.05)。术后2周,观察组NIHSS评分低于对照组(P<0.05),BI评分高于对照组(P<0.05)。观察组GOS分级优于对照组(P<0.05)。术后1周,观察组IL-6、TNF-α水平低于对照组(P<0.05)。观察组并发症发生率(7.69%,3/39)低于对照组(25.64%,10/39),P<0.05。结论与早期显微夹闭比较,血管内介入治疗颅内动脉瘤破裂出血可缩短手术时间,减少术中出血量,减轻炎性反应,改善神经功能障碍,降低并发症发生率,可提高预后效果。Objective To compare the effect of early microsurgical clipping and intravascular intervention on hemorrhage caused by rupture of intracranial aneurysm.Methods A total of 78 patients with hemorrhage caused by rupture of intracranial aneurysm admitted to Zhoukou Central Hospital from February 2021 to February 2023 were selected,and their clinical data were retrospectively analyzed.Among them,39 cases treated by early microsurgical clipping were taken as the control group,and 39 cases treated by endovascular intervention were taken as the observation group.The operation status,National Institutes of Health stroke scale(NIHSS)score,Barthel index(BI)score,Glasgow outcome scale(GOS)grade,levels of inflammatory response indicators,including interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α),and incidence of complications of the two groups were collected and compared.Results The operation time of the observation group was shorter than that of the control group,and the intraoperative blood loss of the observation group was less than that of the control group(P<0.05).Two weeks after operation,the observation group had lower NIHSS score and higher BI score,compared with the control group(P<0.05).The GOS grade of the observation group was better than that of the control group(P<0.05).One week after operation,the levels of IL-6 and TNF-αin the observation group were lower than those in the control group(P<0.05).The incidence of complications in the observation group(7.69%,3/39)was lower than that in the control group(25.64%,10/39),P<0.05.Conclusions Compared with early microsurgical clipping,endovascular intervention in the treatment of hemorrhage caused by rupture of intracranial aneurysm can shorten the operation time,reduce intraoperative blood loss,alleviate inflammatory response,improve neurological dysfunction,reduce the incidence of complications,and improve the prognosis.

关 键 词：颅内动脉瘤 破裂 出血 早期显微夹闭 血管内介入 

分 类 号：R651.12[医药卫生—外科学]