摘要
目的探讨早期显微夹闭术对高级别动脉瘤破裂引起蛛网膜下腔出血(aSAH)的疗效及对其相关血清指标及预后的影响分析。方法选取海安协和福瑞康复医院收治的120例高级别aSAH患者,其中80例患者根据手术治疗时机的不同随机分为研究组及对照组两组(各40例),另取40例aSAH患者作为血管内介入治疗组(患者于出血后48 h内行血管内介入治疗术)。比较研究组(患者于出血后24 h内行显微夹闭手术治疗)、对照组(患者于出血后24~48 h行显微夹闭手术治疗)和血管内介入治疗组患者的临床疗效,并比较各组间治疗前后血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、内皮素-1(ET-1)、一氧化氮(NO)指标及预后情况。结果治疗后研究组患者的临床总有效率(85.0%)高于对照组患者(57.5%)和血管内介入治疗组(55.0%),差异有统计学意义(P<0.05);术前3组患者的相关血清炎性指标比较差异无统计学意义(P>0.05),而术后研究组患者的相关血清炎性指标均较对照组和血管内介入治疗组改善明显,差异有统计学意义(P<0.05);术前3组患者的相关血管内皮功能指标比较差异无统计学意义(P>0.05),而术后研究组患者的相关血管内皮功能指标均较对照组和血管内介入治疗组改善明显,差异有统计学意义(P<0.05)。半年后,研究组患者的研究组患者的预后良好率(85.0%)高于对照组患者(62.5%)和血管内介入治疗组(60.0%),差异有统计学意(P<0.05)。结论早期实施显微夹闭手术治疗高级别aSAH,可提高疗效,同时减轻炎性反应及脑血管痉挛程度并改善患者预后,值得临床推广应用。
Objective To investigate the effects of early microsurgery on subarachnoid hemorrhage(aSAH)caused by rupture of high-grade aneurysms and its influence on serum parameters and prognosis.Methods A total of 120 patients with high-level aSAH were selected,80 of them were randomly divided into study group and control group according to the timing of operation(40 cases each).Another 40 patients with aSAH were selected as the treatment group of intravascular interventional therapy(patients received intravascular interventional therapy within 48 h after bleeding).The clinical efficacy of the study group(patients treated with microsurgery within 24 h after bleeding),the control group(patients treated with microsurgery 24-48 h after bleeding)and the vascular intervention group were compared.The serum levels of TNF-α,IL-1β,Endothelin-1(ET-1),nitric oxide(NO)and prognosis were also compared before and after treatment.Results After treatment,the total clinical effective rate of the study group(85.0%)was higher than that of the control group(57.5%)and the vascular intervention group(55.0%)(P<0.05).There was no significant difference in the related serum inflammatory indexes among the three groups before operation(P>0.05),while the related serum inflammatory indexes of the study group after operation were all higher than those of the control group(P<0.05).There was no significant difference in the related vascular endothelial function indexes between the three groups before operation(P>0.05).The related vascular endothelial function indexes of the study group after operation were significantly improved compared with those of the control group and the vascular intervention group(P<0.05).Six months later,the good prognosis rate of the study group(85.0%)was higher than that of the control group(62.5%)and the vascular intervention group(60.0%)(P<0.05).Conclusion Early microsurgery for high-level aSAH can improve the curative effect,reduce inflammatory reaction and cerebral vasospasm,and improve the prognosis of patients.It is wor
作者
陆娟
李军
崔益秋
LU Juan;LI Jun;CUI Yiqiu(Hai′an Xiehe Furui Rehabilitation Hospital,Hai′an,Jiangsu 226000,China;Department of Neurosurgery,Haian People′s Hospital,Hai′an,Jiangsu 226600,China)
出处
《国际检验医学杂志》
CAS
2019年第20期2542-2545,共4页
International Journal of Laboratory Medicine
关键词
早期显微夹闭术
高级别动脉瘤破裂导致蛛网膜下腔出血
疗效
血清指标
预后
early microsurgery
subarachnoid hemorrhage caused by rupture of high-grade aneurysms
efficacy
serum indicators
prognosis
