血管内介入栓塞术与显微镜下开颅夹闭术对Hunt-HessⅢ级颅内破裂动脉瘤患者手术成功率的影响  

The Effect of Endovascular Interventional Embolization Versus Microscopic Craniotomy on Surgical Success in Patients with Hunt-Hess GradeⅢIntracranial Ruptured Aneurysms

作　　者：高明明 闫惠颖 刘保华 袁璞 朱宗锦 张怀兵 张庆荣 Gao Mingming;Yan Huiying;Liu Baohua(Department of Neurosurgery,Suqian Hospital of Nanjing Drum Tower Hospital Group,Suqian,Jiangsu,223800,China)

机构地区：[1]南京鼓楼医院集团宿迁医院神经外科,江苏宿迁223800 [2]南京鼓楼医院神经外科,江苏南京210000

出　　处：《黑龙江医学》2023年第23期2834-2836,共3页Heilongjiang Medical Journal

基　　金：南京市卫生科技发展专项资金项目(ZKX20013)。

摘　　要：目的:探究实施血管内介入栓塞术与显微镜下开颅夹闭术对Hunt-HessⅢ级颅内破裂动脉瘤患者手术成功率的影响。方法:选取2018年1月—2021年12月南京鼓楼医院集团宿迁医院神经外科诊治的94例Hunt-HessⅢ级颅内破裂动脉瘤患者作为研究对象,根据不同手术治疗方案分为两组,每组各47例患者,研究组实施血管内介入栓塞术,对照组实施显微镜下颅内夹闭术。比较两组患者手术指标、血清中皮质醇(Cor)、D-二聚体(D-D)、白细胞介素-6(IL-6)、肾上腺素(A)指标表达水平、并发症发生情况及手术成功率。结果:与对照组患者相比,研究组患者手术时间和住院时间较短、术中出血量较少,差异有统计学意义(t=3.273、12.416、40.320,P<0.05);术后,两组患者血清中Cor、D-D、IL-6、A指标表达水平均低于术前,且研究组各指标表达水平均低于对照组,差异有统计学意义(t=4.265、3.078、2.174、7.608,P<0.05);研究组患者术后并发症发生率低于对照组,差异有统计学意义(χ^(2)=4.681,P<0.05);两组患者手术成功率比较,差异无统计学意义(χ^(2)=0.178,P>0.05)。结论:对Hunt-HessⅢ级颅内破裂动脉瘤患者实施血管内介入栓塞术治疗能有效减轻手术对患者机体的损伤,降低并发症发生率,促进快速康复,提升手术成功率。显微镜下颅内夹闭术治疗花费较少,且适用范围较广,成功率也较高。Objective:To investigate the effect of performing endovascular interventional embolization and microscopic craniotomy on the surgical success rate of patients with Hunt-Hess gradeⅢintracranial ruptured aneurysms.Methods:94 patients with Hunt-Hess gradeⅢintracranial ruptured aneurysms admitted to the hospital from January 2018 to December 2021 were selected as the study subjects,and were divided into two groups according to different surgical treatment plans,with 47 patients in each group.Endovascular interventional embolization was performed in the study group,and microscopic craniotomy was performed in the control group.The surgical indexes,serum cortisol(Cor),D-Dimer(D-D),interleukin 6(IL-6),adrenaline(A)indexes expression levels,complication occurrences and surgical success rates were compared between the two groups.Results:Compared with patients in the control group,patients in the study group had shorter operative time and hospitalization and less intraoperative bleeding,with statistically significant differences(t=3.273,12.416,40.320,P<0.05).After surgery,the expression levels of Cor,D-D,IL-6,and A indexes in the serum of patients in both groups were lower than those before surgery,and the expression levels of all indexes in the study group were lower than those in the control group,and the difference was statistically significant(t=4.265,3.078,2.174,7.608,P<0.05).The postoperative complication rate of patients in the study group was lower than that of the control group,and the difference was statistically significant(χ^(2)=4.681,P<0.05).The difference in surgical success rate between the two groups was not statistically significant(χ^(2)=0.178,P>0.05).Conclusion:Endovascular interventional embolization of Hunt-Hess gradeⅢintracranial ruptured aneurysm patients can effectively reduce the damage of surgery to the patients’body,reduce the incidence of complications,promote rapid recovery,and improve the success rate of surgery.Microscopic craniotomy is less expensive and has a wider scope of applica

关 键 词：颅内破裂动脉瘤 Hunt-HessⅢ级 血管内介入栓塞术 显微镜下开颅夹闭术 

分 类 号：R73[医药卫生—肿瘤]