摘要
【目的】探讨开颅夹闭与介入栓塞治疗脑动脉瘤性蛛网膜下腔出血(aSAH)患者的临床效果。【方法】回顾性分析2014年2月至2018年5月本院收治的96例aSAH患者的临床资料,根据治疗方式的不同将其分为夹闭组(n=41)和介入组(n=55)。介入组患者采用介入栓塞术治疗,夹闭组患者采用开颅夹闭法治疗。比较两组患者预后、并发症发生率、免疫功能及细胞因子水平变化。【结果】术后7d,介入组患者CD3+、CD8+低于夹闭组,而CD4+、CD4+/CD8+大于夹闭组,差异有统计学意义(P<0.05)。手术前,两组患者血清IL-6、TNF-α水平比较,差异无统计学意义(P>0.05);术后7d,介入组患者血清IL-6、TNF-α水平低于夹闭组,差异有统计学意义(PC0.05)。术后3个月,介入组患者预后优于夹闭组,但差异无统计学意义(P>0.05)。术后3个月,介入组患者并发症发生率为20.0%(11/55),低于夹闭组的56.1%(23/41).差异有统计学意义(P<0.05)。【结论】介入栓塞术治疗aSAH患者的临床效果更佳,对患者免疫功能影响较小,有助于减少并发症的发生率,值得临床推广应用。
[Objective]To investigate the clinical effect of craniotomy clipping and interventional embolization in the treatment of cerebral aneurysmal subarachnoid hemorrhage(aSAH).[Mcthods]The clinical data of 96 patients with aSAH admitted to our hospital from February 2014 to may 2018 were retrospectively analyzed.According to the different treatment methods»they were divided into clipping group(n=41)and interventional group(n=55).The interventional group was treated with interventional embolization«and the clipping group was treated with craniotomy and clipping.The prognosis,incidence of complications,immune function and cytokine levels were compared between the two groups.【Results】At 7 days after operation,CD3+.and C'D8+in the interventional group were lower than those in the clipping group,while CD4+.CD4+/CD8+in the intervention group were higher than those in the clipping group(P<0.05).Before operation,there was no significant difference in serum IL-6 and TNF a levels between the two groups(P>0.05);7 days after operation,the serum IeveLs of IL-6 and TNF~α in the interventional group were lower than those in the clipping group(P<0.05).3 months after operation,the prognosis of the interventional group was better than that of the clipping group,but there was no significant difference(P>0.05).3 months after operation,the complication rate of the interventional group was 20.0%(11/55),which was lower than that of the clipping group 56.1%(23/41),the difference was statistically significant(P〈0.05).【Conclusion】The clinical effect of interventional embolization in the treatment of aSAH patients is better,and it has less impact on the immune function of patients,which helps to reduce the incidence of complications,which is worthy of clinical application.
作者
魏小兵
黄喆
董宇为
李定安
李国强
WEI Xiaobini;HUANG Zhe;DONG Yu-wei(Hanzhong Central Hospital,Hanzhong Shaanxi 723000)
出处
《医学临床研究》
CAS
2020年第10期1542-1544,共3页
Journal of Clinical Research
关键词
蛛网膜下腔出血/外科学
血管外科手术
栓塞
治疗性
Subarachnoid Hemorrhage/SU
Vascular Surgical Procedures
Embolization,Therapeutic
