极早期血管内治疗颅内破裂动脉瘤的临床疗效评价  

Evaluation of the clinical efficacy of extremely early endovascular treatment ofintracranial ruptured aneurysms

作　　者：宋英 刘健[2] 张亮 冀方愿 付辉 SONG Ying;LIU Jian;ZHANG Liang;JI Fangyuan;FU Hui(Department of Neurosurgery,Daxing Teaching Hospital of Capital Medical University,Beijing 102600,China;Department of Neurosurgery,Beijing Tiantan Hospital Affi liated to Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学大兴教学医院神经外科,北京102600 [2]首都医科大学附属北京天坛医院神经外科,北京100070

出　　处：《长春中医药大学学报》2024年第9期1024-1027,共4页Journal of Changchun University of Chinese Medicine

基　　金：北京市属医院科研培育计划项目(PX2022022)。

摘　　要：目的 评价极早期血管内治疗颅内破裂动脉瘤的临床疗效。方法 回顾性分析发病24 h内进行血管内治疗的颅内破裂动脉瘤患者。比较极早期(<8 h)及超早期(9~24 h)血管内治疗2组即刻栓塞程度、术中动脉瘤破裂、血栓形成,术后再出血、新发脑梗死等血管内治疗相关并发症发生率;比较2组之间轻中症组(Hunt-Hess Ⅰ-Ⅲ级)与重症组(Hunt-Hess Ⅳ-Ⅴ级)术后3周及3个月临床良好率。结果 极早期与超早期组即刻栓塞程度、术中动脉瘤破裂、血栓形成,术后再出血、新发脑梗死等相关并发症发生率比较,无统计学差异;极早期与超早期血管内治疗轻中症组术后3周及3个月临床良好率比较,差异有统计学意义(P<0.05);重症组术后3周及3个月临床良好率比较,无统计学差异。结论 极早期血管内治疗颅内破裂动脉瘤可进一步提高患者临床疗效,不增加手术相关并发症。Objective To evaluate the clinical effi cacy of extremely early endovascular treatment of intracranial ruptured aneurysms.Methods The data of patients with intracranial ruptured aneurysms who underwent endovascular treatment within 24 hours after the onset of the disease were retrospectively analyzed.The patients were divided into the extremely early endovascular treatment group(<8 hours)and the ultra-early endovascular treatment group(9-24 hours).The incidence of the degree of immediate embolism,intraoperative aneurysm rupture,thrombosis,postoperative rebleeding,new cerebral infarction and other complications related to endovascular treatment was compared between the extremely early endovascular treatment group and the ultra-early endovascular treatment group.The clinical good rate of patients with mild to moderate symptoms(Hunt-HessⅠ-Ⅲ)and with severe symptoms(Hunt-HessⅣ-Ⅴ)was compared between two groups at 3 weeks and 3 months after surgery.Results There was no statistically signifi cant diff erence in the incidence of the degree of immediate embolism,intraoperative aneurysm rupture,thrombosis,postoperative rebleeding,new cerebral infarction and other related complications between the extremely early endovascular treatment group and the ultra-early endovascular treatment group(P>0.05).There was statistically signifi cant difference in the clinical good rate of patients with mild to moderate symptoms between the extremely early endovascular treatment group and the ultra-early endovascular treatment group at 3 weeks and 3 months after surgery(P<0.05);There was no statistically significant difference in the clinical good rate of patients with severe symptoms between the extremely early endovascular treatment group and the ultra-early endovascular treatment group at 3 weeks and 3 months after surgery(P>0.05).Conclusion Endovascular treatment of intracranial ruptured aneurysms at extremely early stage can further improve the clinicaleffi cacy of patients without increasing the complications related to opera

关 键 词：颅内动脉瘤 破裂 血管内治疗 极早期 超早期 

分 类 号：R459.7[医药卫生—急诊医学]