| 黄 波,刘耀华,潘 磊,李 森,李 勇.颅内动脉瘤夹闭术、血管内栓塞术治疗颅内动脉瘤的疗效及安全性研究[J].,2020,(9):1788-1792 |
| 颅内动脉瘤夹闭术、血管内栓塞术治疗颅内动脉瘤的疗效及安全性研究 |
| Efficacy and Safety of Intracranial Aneurysm Clipping and Endovascular Embolization in the Treatment of Intracranial Aneurysm |
| 投稿时间：2020-01-17 修订日期：2020-02-04 |
| DOI：10.13241/j.cnki.pmb.2020.09.041 |
| 中文关键词: 颅内动脉瘤 颅内动脉瘤夹闭术 血管内栓塞术 炎性因子 并发症 |
| 英文关键词: Intracranial aneurysm Intracranial aneurysm clipping Endovascular embolization Inflammatory factors Complication |
| 基金项目:上海工程技术研究中心资助项目(18DZ2250900) |
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| 中文摘要: |
| 摘要 目的：探讨颅内动脉瘤夹闭术、血管内栓塞术治疗颅内动脉瘤的疗效及安全性。方法：回顾性分析2016年9月-2019年1月接受手术治疗的76例颅内动脉瘤患者的临床资料，根据手术方式的不同分为接受颅内动脉瘤夹闭术治疗的A组40例和接受血管内栓塞术治疗的B组36例。对比两组患者的动脉瘤完全闭合率、住院费用及血清炎性因子[C反应蛋白（CRP）、白介素-1β（IL-1β）、白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）]、脑氧饱和度水平及日常生活能力量表（ADL）评分值，记录并发症发生情况。结果：两组患者的动脉瘤完全闭合率比较差异无统计学意义（χ2＝0.515，P＝0.473）。A组患者的住院费用低于B组患者（t＝17.732，P＝0.000）；A组患者术后血清中CRP、IL-1β、IL-6、TNF-α的水平高于B组（t＝10.580、12.904、9.355、19.176，P均＝0.000）；A组患者术后脑氧饱和度水平低于B组（t＝2.113，P＝0.019），两组ADL评分值的差异无统计学意义（t＝1.211，P＝0.115）；A组术中再破裂、脑血管痉挛发生率高于B组患者（χ2＝4.817、5.383，P＝0.028、0.020）。结论：颅内动脉瘤夹闭术应用于颅内动脉瘤患者，动脉瘤完全闭合率与血管内栓塞术无明显差异，住院费用更低，但对目标血管的刺激较大，可能存在术中再破裂、脑血管痉挛等风险。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the efficacy and safety of intracranial aneurysm clipping and endovascular embolization for intracranial aneurysms. Methods: Clinical data of 76 patients with intracranial aneurysm who underwent surgical treatment from September 2016 to January 2019 were retrospectively analyzed. They were divided into 40 patients in group A who received intracranial aneurysm clipping and 36 patients in group B who received endovascular embolization according to different surgical methods. The complete aneurysm closure rate, hospitalization cost, serum inflammatory factors [CRP, interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor α (TNF-α)], brain oxygen saturation level and daily living ability scale (ADL) score value were compared between the two groups, occurrence of complications were recorded. Results: There was no significant difference in the complete aneurysm closure rate between two groups ( χ2=0.515, P=0.473). The hospitalization cost of group A was lower than that of control group (t=17.732, P=0.000). Postoperative levels of serum CRP, IL-1β, IL-6 and TNF-α of group A were higher than those of group B (t=10.580, 12.904, 9.355, 19.176, all P=0.000). Postoperative brain oxygen saturation level of group A was lower than that of group B (t=2.113, P=0.019). There was no significant difference in ADL score between the two groups (t＝1.211, P=0.115). The incidence of intraoperative re-rupture and cerebral vasospasm of group A were higher than those of group B ( χ2＝4.817, 5.383, P=0.028, 0.020). Conclusion: Early intracranial aneurysm clipping is applied to patients with intracranial aneurysms. The complete aneurysm closure rate and intravascular embolization have no significantly different, and the hospitalization cost is lower, but the stimulation to target vessels is greater, which may lead to the risk of intraoperative re-rupture and cerebral vasospasm. |
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