手术夹闭与介入栓塞治疗对前交通动脉瘤患者认知功能的影响

The Influence of Communicating Artery Aneurysm Clipping Operation and Interventional Embolization on Cognitive Function of Patients

目的:探讨前交通动脉瘤手术夹闭与介入栓塞两种治疗方法对前交通动脉瘤患者认知功能的影响。方法:采用简易精神状态量表(MMSE)对206例前交通动脉瘤患者进行分析对照,其中开颅动脉瘤夹闭患者125例,介入栓塞患者81例,另取正常组40例作为对照组。结果:前交通动脉瘤患者术前即有认知功能障碍发生,术后患者认知功能障碍发生率增高(P<0.01)。患者组的术后认知功能障碍发生率明显高于对照组,而患者组中的介入组的术后认知功能障碍发生率明显小于手术夹闭组(P<0.05)。结论:前交通动脉瘤患者术前既有认知功能障碍发生,两种治疗手段对术前即出现的认知功能障碍无改善作用,并且可能增加认知功能障碍的发生率及加重认知功能障碍的程度,而介入栓塞术在认知障碍的发生率及出现认知功能障碍的程度方面都优于开颅动脉瘤夹闭术。

Objective： Discussion on the influence of commtmicating artery aneurysm clipping operation and interventional embolization on cognitive function of patients. Methods： Analyzing on the result of Mini-Mental State Examination （MMSE） of 206 patients with anterior communicating artery aneurysm,125 cases with communicating artery aneurysm clipping operation and 81 cases with interventional embolization,40 cases of normal as contrast. Results： Patients with anterior communicating artery aneurysm have already had the preoperative cognitive dysfunction ,and the occurrence rate of cognitive dysfunction grows after the operation（P〈0.01 ）. The occurrence rate of cognitive dysfunction of the patients group significantly higher than the normal group, while the occurrence rate of cognitive dysfunction of the interventional embolization group significantly smaller than the clipping operation group （P〈0.05）. Conclusions： Patients with anterior communicating artery aneurysm have already had the preoperative cognitive dysfunction, both of communicating artery aneurysm clipping operation and interventional embolization have no ameliorative effect on it. Instead ,they could both increase the occurrence rate and aggravate the degree. Interventional embolization is better than communicating artery aneurysm clipping operation on the aspect of the occurrence rate of cognitive dysfunction.