介入治疗时机对Hunt-Hess高分级颅内动脉瘤破裂患者的疗效  

Efficacy of interventional therapy time for Hunt-Hess high-grade ruptured intracranial aneurysms patients

作　　者：蔡直铎 邱茜茜 徐晓敏 CAI Zhiduo;QIU Qianqian;XU Xiaomin(Central Hospital of Jiaozuo Coal Industry(Group)Co.,LTD,Jiaozuo 454000,Henan)

机构地区：[1]焦作煤业(集团)有限责任公司中央医院,河南焦作454000

出　　处：《菏泽医学专科学校学报》2025年第1期1-4,共4页Journal of Heze Medical College

摘　　要：目的探讨Hunt-Hess高分级颅内动脉瘤破裂患者在48h内完成血管介入栓塞术治疗的临床效果及对患者的影响。方法选取我院收治的Hunt-Hess高分级(Ⅳ、Ⅴ级)颅内动脉瘤破裂患者97例,根据血管介入栓塞术时机进行分组,超早期组49例在48h内完成血管介入栓塞术,早期组48例在48~96 h内完成血管介入栓塞术,对比两组患者临床疗效、氧化应激反应、神经相关因子水平、术后并发症发生率。结果术后超早期组患者中国脑卒中临床神经功能缺损程度评分量表评分低于早期组,格拉斯预后评分量表评分高于早期组(P<0.05);超早期组患者血清丙二醛评分低于早期组,超氧化物歧化酶评分高于早期组(P<0.05);超早期组患者神经元特异性烯醇化酶水平、髓鞘碱性蛋白水平、基质金属蛋白酶(MMP)-9水平均低于早期组(P<0.05);两组患者术后并发症发生率比较,P>0.05。结论48h内完成血管介入栓塞术治疗可以提高治疗效果,降低患者的氧化应激水平,改善患者的神经相关因子水平。Objective To investigate the clinical effect and influence of vascular interventional embolization within 48 hours on Hunt-Hess high-grade ruptured intracranial aneurysms patients.Methods 97 cases patients with Hunt-Hess high-grade(Ⅳ,Ⅴ)ruptured intracranial aneurysms were selected and grouped according to the time of vascular interventional embolization.49 cases in the ultra-early group completed vascular interventional embolization within 48 hours.The 48 patients in the early group completed vascular interventional embolization within 48~96 h.The clinical efficacy,oxidative stress response,levels of neuro-related factors,and incidence of postoperative complications were compared between the two groups.Results After surgery,the Chinese Stroke Clinical Neurological Impairment Scale score of the ultra-early group was lower than that of the early group,and the Glass Prognosis Scale score was higher than that of the early group(P<0.05).After surgery,the serum malondialdehyde score in ultra-early group was lower than that in early group,and superoxide dismutase score was higher than that in early group(P<0.05).After surgery,the levels of neuron-specific enolase,myelin basic protein and matrix metalloproteinase-9 in ultra-early group were lower than those in early group(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Vascular interventional embolization within 48 h can improve the therapeutic effect of patients,reduce the level of oxidative stress and improve the level of neuro-related factors in patients.

关 键 词：血管介入栓塞术 Hunt-Hess分级法 颅内动脉瘤 神经功能 氧化应激反应 

分 类 号：R543.16[医药卫生—心血管疾病]