早期介入栓塞治疗脑动脉瘤破裂的疗效观察

Clinical effect of early interventional embolization in the treatment of ruptured cerebral aneurysms

目的研究早期介入栓塞治疗脑动脉瘤破裂的临床疗效。方法对本院2014年9月至2015年6月神经外科收治的80例脑动脉瘤破裂患者进行研究分析，分为两组：对照组（40例）和观察组（40例），对照组患者在入院后3d行常规栓塞介入手术治疗，观察组患者在人院3d之内行早期介入栓塞手术治疗，并于本院神经外科成立的专业医护人员进行操作，采用本院研究的《脑动脉瘤破裂栓塞术效果评定标准》对手术栓塞效果进行划分，国际认可的脑卒中（MRS）评分软件对患者神经功能复原情况进行评定；脑卒中MBI评分对患者的日常自理能力进行评判，并统计结果行比较讨论。结果观察组和对照组完全栓塞所占比率比较差异有统计学意义（95．00％比62．25％，P〈0．05）；观察组MRS评分低于对照组【（1．00±0．21）比（2．56±1．09）】，MBI评分比对照组低【（80．12±2．61）比（98．65±1．25）】，在脑积水、蛛网膜下腔出血、动脉瘤再次破裂、复发等并发症情况中对照组的数量均比观察组多，对照组和观察组MRS、MBI评分和各类并发疾病比较差异均有统计学意义（均P〈0．05）。结论脑动脉瘤破裂患者入院3d之内行早期介入栓塞治疗手术，能够提高患者的治疗效果和预后效果，值得在临床上采用和推广。

Objective To study the clinical effect of early interventional embolization in the treatment of ruptured cerebral aneurysms. Methods From Sep. 2014 to Jun. 2015, a total of 80 patients with ruptured cerebral aneurysms in our hospital were taken as the clinical research objects, and divided into control group （40 cases） and observation group （40 cases）. The control group was given conventional interventional embolization three days after admission, and the observation group was given early interventional embolization within three days of admission. All the patients were treated by professional medical staff in neurosurgery department of our hospital. The surgical embolization effect was divided by the evaluation criteria for the embolization effect of ruptured cerebral aneurysm, which was studied in our hospital. The neurological functional recovery was assessed by the international recognition of stroke score software （MRS）, the self-care ability of daily life was evaluated by MBI score for stroke patients. Results The complete embolization rate in the observation group was higher than that in the control group （95.00% vs.62.25%, P〈0.05）; MRS and MBI scores in the observation group were all lower than those in the control group [（1.00±0.21） vs.（2.56±1.09）, （80.12±2.61） vs.（98.65±1.25）; P〈0.05]; the incidences of hydrocephalus, subarachnoid hemorrhage, aneurysm re-rupture, and recurrence in the control group were higher than those in the observation group （P〈0.05）. Conclusion Early interventional embolization for patients with ruptured cerebral aneurysms within three days of admission can improve patients＇ treatment effect and prognosis, worthy of clinical application.