介入栓塞技术治疗前交通动脉瘤破裂临床效果及对患者认知功能的影响

Clinical effect of interventional embolization for patients with ruptured anterior communicating artery aneurysm and their cognitive function

目的探究介入栓塞技术对前交通动脉瘤破裂临床效果及患者认知功能情况的影响。方法回顾性分析收集2016年1月至2017年1月我院接诊的115例前交通动脉瘤破裂患者资料,其中经单纯弹簧圈栓塞71例,球囊辅助弹簧圈21例,支架辅助弹簧圈栓塞23例,同期收取健康人50例为对照组。测试介入栓塞术前、术后认知功能以及患者的临床效果。结果单纯弹簧圈栓塞组完全栓塞29例,大部分栓塞40例,部分栓塞2例;球囊辅助弹簧圈栓塞组完全栓塞16例,大部分栓塞4例,部分栓塞1例;支架辅助弹簧圈栓塞组完全栓塞17例,大部分栓塞3例,部分栓塞3例。与单纯弹簧圈栓塞组比较,囊辅助弹簧圈栓塞组(χ~2=6.886 2,P=0.032 0)和支架辅助弹簧圈栓塞组(χ~2=15.900,P=0.000 4)差异均有统计学意义(P<0.05),且球囊辅助弹簧圈栓塞组与支架辅助弹簧圈栓塞组比较,差异有统计学意义(χ~2=7.280,P=0.026 2)。治疗后认知功能评分情况:单纯弹簧圈栓塞组(24.0±0.2)分与球囊辅助弹簧圈栓塞组(24.3±0.2)分比较,差异有统计学意义(t=86.038 6,P=0.000 0),单纯弹簧圈栓塞组(24.0±0.2)分与支架辅助弹簧圈栓塞组(21.5±0.2)分比较,差异有统计学意义(t=46.384 8,P=0.000 0),球囊辅助弹簧圈栓塞组(24.3±0.2)分与支架辅助弹簧圈栓塞组(21.5±0.2)分比较,差异有统计学意义(t=52.100 2,P=0.000 0)。结果支架辅助弹簧圈栓塞患者认知功能障碍程度明显高于单纯弹簧圈栓塞和球囊辅助弹簧圈栓塞患者。结论不同介入栓塞技术治疗前交通动脉瘤破裂患者疗效满意,并对患者认知功能有不同程度的影响,其中支架辅助弹簧圈栓塞治疗对患者认知功能的影响更显著。

Objective To investigate the effect of interventional embolization on the clinical outcome and cognitive function of patients with anterior communicating artery aneurysm rupture. Methods The data of 120 patients with anterior communicating artery aneurysm rup- ture in our hospital from January 2016 to January 2017 were retrospectively analyzed, in which 71 cases were treated by the spring coil embolization ,21 cases received balloon-assisted coiling,23 cases received stent-assisted coil embolization. At the same time ,50 healthy people were collected as control group. The preoperative, postoperative cognitive function and the clinical effect of the patients were evaluated. Results Coil embolization group completed embolism in 29 cases ,40 cases of most embolism,2 cases of partial embolization; balloon-assisted coiling group completed embolism in 16 cases ,4 cases of most embolism, 1 cases of partial embolization;17 cases of stent assisted coil embolization group completed embolism ,3 cases of most embolism,3 cases of partial embolism. There was statistically significant difference in embolization rate of coil embolization group （X2 = 6. 886 2, P = 0. 032 0 ） , balloon-assisted coiling group （X2 = 15. 900, P = 0. 000 4 ） and stent assisted coil embolization group（x2 = 7. 280, P = 0. 026 2 ）. After the treatment, the difference in cognitive function of coil embolization group（ 24.0 ± 0.2） and balloon-assisted coiling group（ 24.3 ± 0.2 ） was statistically significant（ t = 86. 038 6, P = 0. 000 0） ;the difference between coil embolization group （ 24.0 ± 0.2 ） and balloon-assisted coiling group （ 24.3 ± 0.2 ） was statistically significant （ t = 46. 384 8, P = 0.000 0 ） ; the difference between balloon-assisted coiling group（24.3 ± 0.2 ） and stent assisted coil embolization group （21.5 ± 0.2 ） points was statistically significant（ t = 52. 100 2 ,P = 0. 000 0）. Conclusion Different interventional embolization techniques can improve the cognitive function of patients with ruptured anterior communicating artery aneurysm, which has more obviously effect on the cognitive function of patients with stent assisted coil embolization.