摘要
目的分析应用Pipeline血流导向装置(PED)联合弹簧圈栓塞与开颅夹闭在急性大脑中动脉(MCA)分叉部未破裂动脉瘤中的临床疗效。方法回顾性分析72例急性MCA分叉部未破裂动脉瘤患者的临床资料,根据治疗方法不同将患者分为观察组(37例,PED联合弹簧圈栓塞)与对照组(35例,开颅夹闭治疗)。观察两组患者住院时间、手术时间、手术成功率、复发率、并发症发生率、美国国立卫生研究院卒中量表(NIHSS)、格拉斯哥昏迷评分(GCS)、血流动力学[心输出量(CO)、平均动脉压(MAP)、心脏排血指数(CI)及心率(HR)]。结果观察组住院时间、手术时间、并发症发生率均低于对照组(P<0.05),术后两组NIHSS评分均降低,且观察组低于对照组(P<0.05);观察组GCS评分恢复良好率显著高于对照组(P<0.05);术后两组血流动力学指标均降低,观察组CO、MAP及HR低于对照组,而CI高于对照组(P<0.05)。结论PED联合弹簧圈栓塞与开颅治疗效果相当,但PED联合弹簧圈栓塞能有效缩短治疗手术时间及住院时间、减少术后并发症,促进患者恢复,稳定血流动力学变化,并改善神经功能损伤及预后情况。
Objective To analyze the clinical efficacy of Pipeline blood flow guiding device(PED)combined with coil embolization and craniotomy clipping in the treatment of unruptured middle cerebral artery(MCA)bifurcation aneurysms.Methods The clinical data of 72 patients with unruptured aneurysms at the bifurcation of acute MCA were analyzed retrospectively.According to different treatment methods,the patients were divided into observation group(37 cases,PED combined with coil embolization)and control group(35 cases,craniotomy and clipping).The hospital stay,operation time,operating success rate,recurrence rate,NIHSS,Glasgow coma scale(GCS),hemodynamics[cardiac output(CO),mean arterial pressure(map),cardiac output index(CI)and heart rate(HR)]and complications of the two groups were observed.Results The hospital stay and operating time of the observation group were lower than those of the control group(P<0.05).The NIHSS scores of the two groups were decreased after operation,and the observation group was lower than that of the control group(P<0.05).The good recovery rate of GCS score in the observation group was significantly higher than that in the control group(P<0.05).After operation,the hemodynamic indexes of the two groups were decreased,the CO,map and HR of the observation group were lower than those of the control group,while the CI of the observation group was higher than that of the control group(P<0.05).The incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion PED combined with coil embolization has comparable efficacy to craniotomy,it is effective in reducing the operating time and hospital stay,reducing postoperative complications,promoting patient recovery,stabilizing hemodynamic changes,and improving outcome.
作者
何海胜
胡顺安
华伟
宋才兵
王鹏
HE Hai-sheng;HU Shun-an;HUA Wei(Department of Neurosurgery,Xiangyang Central Hospital,Affiliated Hospital of Hubei University of Arts and Science,Xiangyang 441000,China)
出处
《临床神经外科杂志》
2022年第4期437-440,444,共5页
Journal of Clinical Neurosurgery
