不同时机行血管介入栓塞术治疗颅内动脉瘤的疗效比较
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摘要
目的:比较不同时机行血管介入栓塞术治疗颅内动脉瘤的疗效。方法:回顾性分析作者收治的2015年3月至2018年3月102例行血管介入栓塞术治疗颅内动脉瘤患者的临床资料,根据患者介入时机的不同,其中发病距治疗时间不超过72h者为A组(54例),发病距治疗时间超过72h者为B组(48例)。比较两组患者栓塞程度、改良Rankin量表、神经功能缺损量表及MOS健康状况调查问卷(SF-36)的评分差异。结果:相比B组(58.33%),A组完全栓塞率(81.48%)明显升高(P<0.05)。术后3个月,两组患者改良Rankin量表评分较治疗前均显著减少,且A组术后评分较B组评分显著减少(P<0.01)。与术前相比,两组患者术后3个月神经功能缺损量表评分均显著下降,且A组术后评分较B组评分显著下降(P<0.01)。相比术前,两组患者术后3个月SF-36量表评分显著升高,且A组术后评分较B组评分显著升高(P<0.05)。结论:相比发病距治疗时间超过72h者,发病距治疗时间不超过72h内行血管介入栓塞术可有效改善颅内动脉瘤患者的临床疗效,对改善患者预后效果和神经功能及提高生活质量具有重要作用,适宜临床推广。
Objective: To compare the therapeutic effects of interventional embolization of intracranial aneurysms at different times. Methods: The clinical data of 102 patients with intracranial aneurysms treated by interventional embolization in our hospital from March 2015 to March 2018 were retrospectively analyzed. According to the timing of interventional therapy, group A(54 cases) had the onset time less than 72 hours, and group B(48 cases) had the onset time longer than 72 hours. The scores of embolism degree, modified Rankin scale, neurologic function impairment scale and MOS 36-items short form-health survey(SF-36) were compared between the two groups. Results: Compared with group B(58.33%), the complete embolization rate in group A(81.48%) was significantly increased(P< 0.05). Three months after operation, the scores of modified Rankin scale in both groups were significantly decreased compared with those before treatment, and the score in group A was significantly decreased compared with group B(P< 0.01). Compared with the preoperative scores, the scores of neurologic function impairment scale in both groups decreased significantly at 3 months after operation, and the score in group A was significantly decreased compared with those in group B(P< 0.01). Compared with pre-operation, the scores of SF-36 scale in two groups were significantly higher at 3 months after operation, and the scores in group A were significantly higher than those in group B(P< 0.05). Conclusion: Compared with the patients whose time between onset and treatment is more than 72 hours, interventional embolization within 72 hours can effectively improve the clinical efficacy of intracranial aneurysms, and play an important role in improving the prognosis, neurological function and quality of life of patients. Therefore, it should be popularized in clinic.
Objective: To compare the therapeutic effects of interventional embolization of intracranial aneurysms at different times. Methods: The clinical data of 102 patients with intracranial aneurysms treated by interventional embolization in our hospital from March 2015 to March 2018 were retrospectively analyzed. According to the timing of interventional therapy, group A(54 cases) had the onset time less than 72 hours, and group B(48 cases) had the onset time longer than 72 hours. The scores of embolism degree, modified Rankin scale, neurologic function impairment scale and MOS 36-items short form-health survey(SF-36) were compared between the two groups. Results: Compared with group B(58.33%), the complete embolization rate in group A(81.48%) was significantly increased(P< 0.05). Three months after operation, the scores of modified Rankin scale in both groups were significantly decreased compared with those before treatment, and the score in group A was significantly decreased compared with group B(P< 0.01). Compared with the preoperative scores, the scores of neurologic function impairment scale in both groups decreased significantly at 3 months after operation, and the score in group A was significantly decreased compared with those in group B(P< 0.01). Compared with pre-operation, the scores of SF-36 scale in two groups were significantly higher at 3 months after operation, and the scores in group A were significantly higher than those in group B(P< 0.05). Conclusion: Compared with the patients whose time between onset and treatment is more than 72 hours, interventional embolization within 72 hours can effectively improve the clinical efficacy of intracranial aneurysms, and play an important role in improving the prognosis, neurological function and quality of life of patients. Therefore, it should be popularized in clinic.
引文
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[2] 林宇佳,张国栋,廖政贤,等.双容积图像融合技术在颅内动脉瘤介入血管内栓塞术中的作用[J].实用医学杂志,2017,33(10):1685～1688.
[3] 中华医学会神经外科学分会神经介入学组.颅内动脉瘤血管内介入治疗中国专家共识(2013)[J].中华医学杂志,2013,93(39):3093～3103.
[4] 姚志明.栓塞与夹闭方法治疗颅内动脉瘤的临床效果比较[J].中国基层医药,2018,25(3):299～301.
[5] 曾光,洪明,徐岩,等.颅内动脉瘤性蛛网膜下腔出血不同时机开颅手术及血管内治疗的疗效及预后因素分析[J].河北医学,2017,23(1):63～65.
[6] 张睿,陈灿中.开颅夹闭与血管介入栓塞术治疗老年脑动脉瘤患者的临床效果观察[J].检验医学与临床,2017,14(Z1):299～300.
[7] Shi L,Yuan Y,Guo Y,et al.Intracranial post-embolization residual or recurrent aneurysms:current management using surgical clipping[J].Interv Neuroradiol,2016,22(4):413～419.
[8] Texakalidis P,Bekelis K,Atallah E,et al.Flow diversion with the pipeline embolization device for patients with intracranial aneurysms and antiplatelet therapy:A systematic literature review[J].Clin Neurol Neurosurg,2017,161(1):78～87