摘要
目的探讨血管内栓塞术和显微外科夹闭术对前循环颅内动脉瘤患者临床预后及安全性的影响。方法研究对象选取本院2015年4月-2017年10月收治前循环颅内动脉瘤患者共104例,以随机数字表法分为夹闭组(52例)和栓塞组(52例),分别采用显微外科夹闭术和腔内介入栓塞术治疗,比较2组手术相关临床指标水平、术后GOS分级、mRS评分、生活质量、手术前后炎症相关指标水平及术后并发症发生率。结果栓塞组术后总住院时间显著短于夹闭组(P<0.05);栓塞组住院总费用显著多于夹闭组(P<0.05);栓塞组术后6个月GOS分级、术后6个月mRS评分、出院时SF-36评分及术后6个月BI评分显著优于夹闭组(P<0.05);栓塞组术后7 d炎症相关指标水平均显著低于对照组、术前(P<0.05);同时2组瘤体破裂和缺血性脑卒中发生率比较无显著性差异(P>0.05);夹闭组血管痉挛发生率显著低于栓塞组(P<0.05);栓塞组颅内感染发生率显著低于夹闭组(P<0.05)。结论腔内介入栓塞术治疗前循环颅内动脉瘤可显著加快术后康复进程,减轻病变严重程度,提高生存质量,降低炎症反应水平,并有助于避免颅内感染出现,而显微外科夹闭术应用则能够减少医疗费用,预防血管痉挛发生。
Objective To investigate the influence of intravascular embolization and micropinch on clinical prognosis and safety of patients with anterior circulation intracranial aneurysms.Methods 104 patients with anterior circulation intracranial aneurysms were chosen in the period from April 2015 to October 2017 and randomly divided into 2 groups including micropinch group(52 patients) with micropinch and embolization group (52 patients) with intravascular embolization,and the surgery-related clinical indicators,postoperative GOS classification,mRS score,quality of life score,preoperative and postoperative inflammatory related indicators and postoperative complication incidence of both groups were compared.Results The hospitalization time of embolization group were significant shorter than that of micropinch group (P<0.05).The total treatment cost of micropinch group were significant less than that of embolization group (P<0.05).The GOS classification after operation,mRS score,SF-36 score and BI score after operation of embolization group were significant better than those of micropinch group(P<0.05).The levels of postoperative inflammatory related indicators of embolization group were significant lower than those of micropinch group and before operation (P<0.05).There was no significant difference in the incidence of aneurysm rupture and cerebral ischemia between2 groups (P>0.05).The vasospasm incidence of embolization group were significant higher than that of micropinch group (P<0.05).The infection incidence of embolization group were significant lower than that of micropinch group (P<0.05).Conclusion Intravascular embolization in the treatment of patients with anterior circulation intracranial aneurysms could efficiently accelerate the postoperative rehabilitation process,reduce the disease severity,improve the quality of life,reduce the levels of inflammatory reaction and be helpful to avoid intracranial infection,and micropinch application had the advantages including reducing the medical treatment cost and preventing the vasospasm occurrence.
作者
张继东
Zhang Jidong(Department of Neurosurgery ,Nanyang Nan Shi Hospital,Nanyang 473000)
出处
《卒中与神经疾病》
2018年第6期693-696,共4页
Stroke and Nervous Diseases
