摘要
目的探讨Lvis支架辅助弹簧圈与电解可脱卸弹簧圈栓塞在治疗颅内宽颈动脉瘤的临床疗效及并发症分析。方法选择2017年1月—2018年5月本院收治的70例颅内宽颈动脉瘤患者作为研究对象,按照随机数表法分为实验组和对照组两组,每组各35例。实验组给予Lvis支架辅助弹簧圈栓塞治疗,对照组给予常规电解可脱卸弹簧圈治疗。比较两组患者临床指标、两组治疗颅内宽颈动脉瘤患者治疗前后大脑中动脉平均血流速度、术后不同时间点(术后即刻、3个月、6个月、12个月)Raymond分级与格拉斯哥预后评分(GOS)、术后即时填塞率、复发率及围手术期并发症发生情况。结果实验组患者手术时间、术中出血量及住院时间均分别明显少于对照组,差异有统计学意义(P<0.05);治疗后,两组患者大脑中动脉平均血流速度明显升高,且实验组患者大脑中动脉平均血流速度明显高于对照组,差异有统计学意义(P<0.05);术后3个月、6个月、12个月,两组患者Raymond分级评估均低于术后即刻,差异有统计学意义(P<0.05);且实验组下降幅度明显大于对照组,差异有统计学意义(P<0.05);术后3个月、6个月、12个月,两组患者GOS评分均高于术后即刻,差异有统计学意义(P<0.05);且实验组上升幅度明显大于对照组,差异有统计学意义(P<0.05);实验组患者术后即时填塞率为74.29%(26/35),明显高于对照组的51.43%(18/35)(P<0.05);术后跟踪随访期间实验组患者复发率为5.71%(2/35),明显低于对照组的17.14%(6/35)(P<0.05);实验组颅内宽颈动脉瘤患者围手术期并发症发生率(14.29%)明显低于对照组(34.29%),差异有统计学意义(P<0.05)。结论采用Lvis支架辅助弹簧圈栓塞治疗颅内宽颈动脉瘤较电解可脱卸弹簧圈栓塞治疗效果好,其可有效增加脑血管供血与促进血栓形成,且患者术后即时填塞率高、复发率及围手术期并发症发生率较低,值得推广应用。
Objective To discuss the clinical efficacy and complications of Lvis stent assisted coil and guglielmidetachable coil embolization in the treatment of intracranial wide-necked aneurysms.Methods According to the computer-generated random number table method,70 patients with intracranial wide-necked aneurysms those admitted to the hospital form Jan 2017 to May 2018 were enrolled as study subjects and they were divided into the experimental group treated with Lvis stent-assisted coil embolization(n=35)and the control group treated with conventional detachable coils(n=35).The clinical indicators,average blood flow velocity of middle cerebral artery before and after treatment,Raymond classification and GOS scale score at different time points postoperative(immediately,3 months,6 months,12 months after operation),postoperative immediate tamponade rate,recurrence rate and the occurrence situation of perioperative complications of the two groups were compared.Results The operative time,intraoperative bleeding volume and length of stay of the experimental group were significantly less than the control group,the differences were statistically significant(P<0.05).After the treatment,the average blood flow velocity of middle cerebral artery in both groups increased significantly,and the average blood flow velocity of middle cerebral artery of the experimental group was higher than that of the control group,the difference was statistically significant.The Raymond classification of the experimental group and the control groupat 3 rd,6 th and 12 th month after operation were significantly lower than those at immediately after operation,the differences were statistically significant(P<0.05).And the decrease amplitude in the experimental group was higher than that in the control group(P<0.05).The postoperative GOS scores of the experimental group and the control group at 3 rd,6 th and 12 th month after operation were significantly higher than those at immediately after operation,the differences were statistically significant(P<0.
作者
郑达理
杨建雄
林立超
Zheng Dali(Neurosurgery department,Heyuan people's hospital,Heyuan,Guangdong,517000,China)
出处
《齐齐哈尔医学院学报》
2021年第14期1214-1218,共5页
Journal of Qiqihar Medical University
基金
河源市社会发展科技计划项目(170608210221362)。
