应用内支架植入辅助弹簧圈栓塞治疗颅内动脉瘤57例

Application of stent implantation assisting coil embolization in the treatment of 57 cases with intracranial aneurysm

目的观察血管内支架植入辅助弹簧圈栓塞治疗颅内动脉瘤的效果。方法选取武警四川总队医院神经外科2013-08—2016-10颅内动脉瘤患者114例,依照术式不同分为对照组和观察组各57例。观察组采取血管内支架植入辅助弹簧圈栓塞术,对照组采取开颅夹闭术。对比2组术前、术后1周神经功能缺损评分(NIHSS)与血清sICAM-1、S100β蛋白水平及术前、术后1a生活质量评分(QOL),并比较2组术后并发症发生率与术后1a复发率、预后情况。结果术前2组NIHSS评分对比,差异无统计学意义(P>0.05),术后1周2组NIHSS评分均较术前降低,且观察组低于对照组(P<0.05);术后1周2组血清sICAM-1、S100β蛋白水平均较术前降低,且观察组低于对照组(P<0.05);观察组术后并发症发生率10.53%(6/57)低于对照组24.56%(14/57),差异有统计学意义(P<0.05);术后1a2组QOL评分均较术前提高,且观察组高于对照组(P<0.05);观察组术后1a复发率1.75%(1/57)低于对照组14.04%(8/57),预后情况优于对照组,差异有统计学意义(P<0.05)。结论应用血管内支架植入辅助弹簧圈栓塞治疗颅内动脉瘤患者效果肯定,可有效降低其术后血清sICAM-1、S100β蛋白水平及神经功能损伤程度,减少并发症发生情况及复发情况,改善其生活质量及预后情况。

Objective To observe the effect of endovascular stent implantation assisting coil embolization in the treatment of patients with intracranial aneurysms.Methods A total of 114 cases with intracranial aneurysms in our hospital from August 2013 to October 2016 were divided into the control group and the observation group according to different operation methods,57 cases in each group.The observation group was treated with endovascular stent implantation assisting coil embolization,and the control group was treated with craniotomy clipping.The neurological deficit score（NIHSS）score and levels of serum sICAM-1,S100β protein before and 1 week after operation,and the quality of life score（QOL）before and 1 year after operation were compared between the two groups.The incidence of postoperative complications and recurrence rate in 1 year after operation and prognosis were compared between the two groups.Results There was insignificant difference in NIHSS scores between the two groups before operation（P0.05）.1 week after operation,the NIHSS scores of the two groups were lower than those before the operation,and the observation group was lower than the control group（P0.05）.After 1 week,the levels of serum sICAM-1 and S100β protein of the two groups were lower than those before operation,and the observation group was lower than the control group（P0.05）.The incidence of postoperative complications in the observation group was 10.53%（6/57）,which was lower than that of the control group 24.56%（14/57）,and the difference was statistically significant（P0.05）.1 year after operation,the QOL scores of two groups were all higher than those before operation,and the observation group was higher than the control group（P0.05）.The recurrence rate of the observation group after 1 year 1.75%（1/57）was lower than that of the control group 14.04%（8/57）,and the prognosis of the observation group was better than that of the control group.The difference was statistically significant（P0.05）.Conclusion The application of endovascular stent implantation assisting coil embolization in patients with intracranial aneurysms has positive effect.It can effectively reduce the postoperative serum sICAM-1,S100 protein levels and neurologic functional damage,reduce the occurrence of complications and recurrence,and improve their quality of life and prognosis.