介入栓塞术治疗前循环动脉瘤的临床疗效及对神经功能的影响  

Clinical Efficacy of Interventional Embolization in the Treatment of Anterior Circulation Aneurysms and Influence on Neurological Function

作　　者：聂文 叶林 陈森 刘娟 祁晓瑜 NIE Wen;YE Lin;CHEN Sen;LIU Juan;QI Xiaoyu(Department of Neurosurgery,Jiaozhou Hospital,Dongfang Hospital affiliated to Tongji University,Qingdao,Shandong Province,266300 China;Intensive Care Unit,Jiaozhou Hospital,Dongfang Hospital affiliated to Tongji University,Qingdao,Shandong Province,266300 China;Department of International Medical,Jiaozhou Hospital,Dongfang Hospital affiliated to Tongji University,Qingdao,Shandong Province,266300 China)

机构地区：[1]同济大学附属东方医院胶州医院神经外科,山东青岛266300 [2]同济大学附属东方医院胶州医院重症监护室,山东青岛266300 [3]同济大学附属东方医院胶州医院国际医学部,山东青岛266300

出　　处：《中外医疗》2024年第11期66-70,共5页China & Foreign Medical Treatment

摘　　要：目的探讨介入栓塞术治疗前循环动脉瘤的临床疗效及对神经功能的影响。方法回顾性选取2022年2月—2023年4月同济大学附属东方医院胶州医院神经外科收治的80例前循环动脉瘤患者的临床资料。根据手术方式不同分为观察组(介入栓塞)与对照组(显微动脉瘤夹闭术),各40例。比较两组手术持续时间及术后住院时间,比较两组手术前后钙结合蛋白B和神经元特异性烯醇化酶水平变化情况,统计两组并发症发生情况及半年内神经功能预后分级情况。结果观察组手术持续时间为(56.5±12.4)min,短于对照组,术后住院时间为(10.4±2.2)d,短于对照组,差异有统计学意义(P均<0.05)。术后,观察组钙结合蛋白B及神经元特异性烯醇化酶水平分别为(9.3±1.5)、(8.7±1.5)ng/mL,均显著高于对照组,差异有统计学意义(t=4.779、6.495、P均<0.05)。观察组颅内感染、动脉瘤破裂、脑梗死、短暂性脑血管痉挛及脑积水的总发生率(2.5%)显著低于对照组(15.0%),差异有统计学意义(χ^(2)=3.914,P<0.05),观察组的预后良好率高于对照组,病死率低于对照组,差异有统计学意义(P均<0.05)。结论介入栓塞术治疗前循环动脉瘤具有创伤小,术后神经功能恢复快,并发症少,安全性高,临床效果可靠的优势,对于促使患者早期出院有积极意义。Objective To investigate the clinical effect of interventional embolization in the treatment of anterior circulation aneurysms and influence on neurological function.Methods The clinical data of 80 patients with anterior circulation aneurysm admitted from February 2022 to April 2023 in Jiaozhou Hospital,Dongfang Hospital affiliated to Tongji University were selected retrospectively.According to the different surgical methods,they were divided into the observation group(interventional embolization)and control group(microsurgical aneurysm clipping),with 40 cases each.Then the operation duration and postoperative hospitalization time and the changes of S-100 calcium binding protein B(S-100B)and neuron-specific enolase(NSE)levels before and after the operation were compared.The incidence of complications and the prognosis grading of neurological function were counted.Results The operation duration of the observation group was(56.5±12.4)min,which was shorter than that of the control group,and the postoperative hospitalization time was(10.4±2.2)d,which was shorter than that of the control group,the differences were statistically significant(both P<0.05).After operation,the levels of S-100B and NSE in the observation group were(9.3±1.5)ng/mL,(8.7±1.5)ng/mL,respectively,which were significantly higher than those in the control group,and the differences were statistically significant(t=4.779,6.495,both P<0.05).The total incidence of intracranial infection,aneurysm rupture,cerebral infarction,transient cerebral vasospasm and hydrocephalus in the observation group(2.5%)was significantly lower than that in the control group(15.0%),the difference was statistically significant(χ^(2)=3.914,P<0.05).The good prognosis rate of the observation group was higher than that of the control group,and the mortality rate was lower than that of the control group,the differences were statistically significant(both P<0.05).Conclusion Interventional embolization with anterior circulation aneurysms has less advantages and can rapidly recov

关 键 词：介入栓塞术 开放夹闭术 前循环动脉瘤 临床预后 神经功能 

分 类 号：R743[医药卫生—神经病学与精神病学]