不同时机介入栓塞术治疗Hunt-Hess Ⅳ～Ⅴ级颅内动脉瘤出血的疗效及安全性比较

Comparison of the efficacy and safety of interventional embolization at different time in the treatment of Hunt-Hess Ⅳ-Ⅴ intracranial aneurysm hemorrhage

目的探讨不同时机介入栓塞术治疗Hunt-HessⅣ~Ⅴ级颅内动脉瘤出血的疗效及安全性。方法选取自2016年1月至2018年1月在黄冈市中心医院介入科进行治疗的Hunt-HessⅣ~Ⅴ级颅内动脉瘤出血患者共120例,按照介入时机分为早期组(<48 h)、中期组(2~14 d)和晚期组(>14 d),每组40例。3组患者均使用栓塞术治疗,对比其治疗情况、治疗安全性和机体恢复情况。结果 3组患者介入栓塞术的治疗有效率比较,差异无统计学意义(P>0.05)。3组患者的不良反应发生率比较,差异有统计学意义(P<0.05),且早期组<中期组<晚期组。3组患者治疗前的Barthel指数评分比较,差异无统计学意义(P>0.05)。治疗后,3组患者的机体恢复情况均随时间的推移而进一步好转,且早期组的恢复情况最佳,晚期组最差。结论虽然介入栓塞术的治疗时机无法直接提高颅内动脉瘤出血患者的治疗效果,但能有效提高患者的机体恢复速度,降低不良反应发生率。

Objective To investigate the efficacy and safety of interventional embolization at different time in the treatment of Hunt-Hess Ⅳ-Ⅴ grade intracranial aneurysm. Methods One hundred and twenty cases of Hunt Hess Ⅳ-Ⅴ intracranial aneurysm bleeding from January 2016 to January 2018 were selected and treated in the Department of Interventional, Huanggang Central Hospital. According to the time of intervention, they were divided into early group(<48 h), middle group(2-14 d) and late group(>14 d), 40 cases in each group. Three groups of patients were treated with embolization, the treatment, safety and recovery of the 3 groups were compared. Results There was no significant difference among the 3 groups in the effective rate of interventional embolization( P >0.05).The incidence of adverse reactions in the 3 groups was statistically significant(P<0.05), the early group was the best, the middle group was the worse, and the late group was the worst. There was no significant difference in Barthel index score before treatment among the 3 groups(P >0.05). After treatment, the recovery of the 3 groups improved with the passage of time, and the recovery of the early group was the best, the late group was the worst. Conclusion Although the time of interventional embolization can not directly improve the therapeutic effect for patients with intracranial aneurysm bleeding, it can effectively improve the recovery speed of patients and reduce the incidence of adverse reactions.