Surpass Streamline血流导向装置在颅内动脉瘤手术治疗中的应用  

Application of Surpass Streamline flow diverter in surgical treatment of intracranial aneurysms

作　　者：王蒙 张霜 廖莎 刘冰 杜随 Wang Meng;Zhang Shuang;Liao Sha;Liu Bing;Du Sui(Department of General Surgery Second Ward,The First affiliated Hospital of Nanyang Medical College,Nanyang 473000,China;Department of Neurosurgery,Nanyang Central Hospital,Nanyang 454001,China)

机构地区：[1]南阳医学高等专科学校第一附属医院普通外科二病区,南阳473000 [2]南阳市中心医院神经外科,南阳454001

出　　处：《中国临床实用医学》2024年第2期62-66,共5页China Clinical Practical Medicine

基　　金：2020年度河南省医学科技攻关项目(SBGJ20201231)。

摘　　要：目的观察Surpass Streamline血流导向装置(FD)在颅内动脉瘤手术中的应用效果。方法本研究为前瞻性随机对照研究,选取2021年1月至2023年7月南阳医学高等专科学校第一附属医院普通外科二病区收治的86例颅内动脉瘤患者,男45例,女41例,年龄(65.23±5.25)岁,年龄范围为50~80岁。采用计算机随机分组法将患者随机分为常规组与FD组,每组43例。常规组采用血管内介入栓塞术治疗,FD组采用FD治疗,比较两组患者术后即刻数字减影血管造影(DSA)检查结果、围术期不良事件发生率、血管内皮功能[纤溶酶原激活抑制物(PAI-1)、组织型纤溶酶原激活物(t-PA)、内皮素-1]、神经功能[半乳糖凝集素3(Gal3)、粒细胞巨噬细胞-集落刺激因子(GM-CSF)、神经肽Y]及预后情况[格拉斯哥预后指数(GOS)、改良Fisher量表(mFS)]。结果FD组患者的瘤体完全显影率[32.6%(14/43)]高于常规组[2.3%(1/43)],完全闭塞率[51.2%(22/43)]低于常规组[76.7%(33/43)],围术期不良事件发生率[4.7%(2/43)]低于常规组[23.3%(10/43)],差异有统计学意义(P<0.05)。治疗后,FD组的PAI-1[(12.31±3.24)μg/L]、t-PA[(3.42±0.41)μg/L]、内皮素-1[(50.38±10.31)ng/L]、Gal3[(5.45±1.33)μg/L]、GM-CSF[(8.31±1.26)×10^(3)/mm^(3)]、神经肽Y[(185.66±20.41)pg/ml]、mFS评分[(1.41±0.25)分]均低于常规组[(14.88±3.61)μg/L、(4.25±1.77)μg/L、(55.29±10.42)ng/L、(6.33±1.82)μg/L、(10.41±2.45)×10^(3)/mm^(3)、(201.47±20.45)pg/ml、(2.46±0.88)分],GOS[(4.61±1.32)分]高于常规组[(3.72±0.85)分],差异均有统计学意义(P<0.05)。结论Surpass Streamline FD治疗能改善颅内动脉瘤患者的术后即刻造影结果,对降低围术期不良事件发生风险、改善血管内皮功能、神经功能及患者预后情况均有积极意义。Objective Observe the application effect of Surpass Streamline flow diverter(FD)in surgical treatment of intracranial aneurysms.Methods This study was a prospective randomized controlled study,a total of 86 patients with intracranial aneurysms admitted to department of General Surgery Second Ward in the First Affiliated Hospital of Nanyang Medical College from January 2021 to July 2023,including 45 males and 41 females,aged(65.23±5.25)years old,ranging from 50 to 80 years old.Using computer random grouping method,patients were randomly divided into conventional group and FD group,with 43 cases in each group.The conventional group received endovascular embolization treatment,while the FD group received FD treatment.The results of immediate postoperative digital subtraction angiography(DSA),incidence of perioperative adverse events,vascular endothelial function[plasminogen activator inhibitor(PAI-1),tissue-type plasminogen activator(t-PA),endothelin-1],neurological function[Galectin-3(Gal3),granulocyte-macrophage colony stimulating factor(GM-CSF),neuropeptide Y]and prognosis[Glasgow outcome scale(GOS),modified Fisher scale(mFS)]were compared between the two groups.Results The complete tumor development rate[32.6%(14/43)]in the FD group was higher than that in the conventional group[2.3%(1/43)],the complete occlusion rate[51.2%(22/43)]was lower than that in the conventional group[76.7%(33/43)],the incidence of perioperative adverse events[4.7%(2/43)]was lower than that in the conventional group[23.3%(10/43)],and the differences were statistically significant(P<0.05).After treatment,PAI-1 in the FD group[(12.31±3.24)μg/L],t-PA[(3.42±0.41)μg/L],endothelin-1[(50.38±10.31)ng/L],Gal3[(5.45±1.33)μg/L],GM-CSF[(8.31±1.26)×10^(3)/mm^(3)],neuropeptide Y[(185.66±20.41)pg/ml],mFS score[(1.41±0.25)points]were lower than those in the conventional group[(14.88±3.61)μg/L,(4.25±1.77)μg/L,(55.29±10.42)ng/L,(6.33±1.82)μg/L,(10.41±2.45)×10^(3)/mm^(3),(201.47±20.45)pg/ml,(2.46±0.88)points],the GOS score[(4.61±1.3

关 键 词：颅内动脉瘤 血管内介入栓塞术 Surpass Streamline血流导向装置 血管内皮功能 神经功能 

分 类 号：R651.12[医药卫生—外科学]