眶上外侧入路显微夹闭术治疗老年前交通动脉瘤破裂急性期的临床疗效及对TGF-β、SDF-1A水平的影响  

Clinical efficacy of microclipping of the superior lateral orbital approach for the acute phase of senile anterior communicating aneurysm rupture and its effect on TGF-βand SDF-1A levels

作　　者：李浩 张海龙 Li Hao;Zhang Hailong(Xinyang City Central Hospial,Henan,Xinyang,46099)

机构地区：[1]信阳市中心医院,河南信阳464099

出　　处：《辽宁医学杂志》2024年第6期68-72,共5页Medical Journal of Liaoning

摘　　要：目的 探讨眶上外侧入路显微夹闭术应用于老年前交通动脉瘤(ACoAA)破裂急性期患者的临床疗效及对转化生长因子(TGF-β)、基质细胞衍生因(SDF-1A)水平的影响。方法 回顾性分析该院2021年3月至2023年3月期间126例老年ACoAA破裂急性期患者的临床资料,予眶上外侧入路(LSO)显微夹闭术治疗者作为观察组(n=63),予常规翼点入路(PT)显微夹闭术治疗者作为对照组(n=63),观察两组围术期相关指标、炎症相关因子[白细胞介素(IL-8)、肿瘤坏死因子(TNF-α)、转化生长因子(TGF-β)、基质细胞衍生因子(SDF-1A)]、认知功能以及并发症发生情况。结果 观察组术中出血量较对照组出血量少(P<0.05),手术用时、切口长度以及术后住院时间均较对照组短(P<0.05);术后,两组SDF-1A、TGF-β、TNF-α、IL-8水平均较术前降低,且观察组水平低于对照组水平(P<0.05);术后1个月,两组简明精神状态评估(MMSE)量表、特利尔认知评估(MoCA)量表得分均较术前降低,但观察组患者MMSE、MoCA得分较对照组得分高(P<0.05);观察组总并发症发生率(4.76%)低于对照组发生率(17.46%)(P<0.05)。结论 采用LSO入路显微夹闭术对老年ACoAA破裂急性期患者进行治疗可以减少其术中出血和手术损伤,抑制炎症反应水平,促进认知功能恢复,且与传统入路显微夹闭术相比,安全性更好。Objective To investigate the clinical efficacy of lateral orbital approach in the acute stage of anterior com-municating artery aneurysm(ACoAA)and the effect of transforming growth factor(TCF-β)in(SDF-1A).Methods sThe clinical data of 126 elderly patients in the acute phase of ACoAA rupture between March 2021 and March 2023 were also analyzed more recently,Treatment with the superior lateral orbital approach(LSO),as the observation group(n=63),To conventional wing point approach(PT)as control group(n=63),Peri-related indicators,inflammation-related factors[inter-leukin(IL-8),tumor necrosis factor(TNF-α),transforming growth factor(TCF-β),stromal cell-derived factor(SDF-.1A)],cognitive function and complications were observed in both groups.Results The intraoperative bleeding volume in the observed group was less than that in the control group(P<0.05),Surgical time,incision length and postoperative hospi-tal stay were shorter than the control group(P<0.05);postoperative,Both groups,the levels of SDF-1A,TCF-β,TNF-α,and IL-8 were decreased compared with the preoperative levels,And the level of the observation group was lower than that of the control group(P<0.05);One month after the surgery,The Brief Mental State Assessment(MMSE)scale and the Trier Cognitive Assessment(MoCA)scale were decreased than the preoperative scores,However,the MMSE and MoCA scores in the observation group were higher than those in the control group(P<0.05);The overall complication rate in the observa-tion group(4.76%)was lower than that in the control group(17.46%)(P<0.05).Conclusion The elderly patients with LSO approach can reduce intraoperative bleeding and surgical damage,inhibit the level of inflammatory response,and pro-mote the recovery of cognitive function,and have better safety compared with the traditional approach microclipping.

关 键 词：显微夹闭术 前交通动脉 动脉瘤 基质细胞衍生因子 

分 类 号：R651.12[医药卫生—外科学]