血管内介入栓塞与开颅夹闭术对脑动脉瘤临床治疗效果及预后的影响比较

Comparison of effects of intravascular interventional embolization and craniotomy on clinical treatment and prognosis of cerebral aneurysms

目的比较血管内介入栓塞与开颅夹闭术对脑动脉瘤临床治疗效果及预后的影响。方法选取我院2017年1月—2019年6月期间接诊的50例脑动脉瘤患者为研究对象,根据手术方式分为栓塞组和夹闭组,每组25例。栓塞组患者采取血管内介入栓塞的方法进行治疗,夹闭组患者采用开颅夹闭术,采用免疫比浊法检测2组患者术前和术后的血清免疫球蛋白水平,同时记录术后并发症发生情况。进行为期半年的随访,利用格拉斯哥预后量表评价术后恢复情况。结果治疗后,2组患者的血清免疫球蛋白水平(IgG、IgA、IgM)较治疗前均显著下降,且夹闭组患者低于栓塞组(P<0.05);栓塞组患者的并发症发生率显著低于夹闭组(P<0.05)。随访6个月,栓塞组患者预后良好率为84.00%,显著高于夹闭组的64.00%,差异有统计学意义(P<0.05)。结论对脑动脉瘤患者采取血管内介入栓塞治疗,相比于开颅夹闭术能显著改善症状,减少术后并发症的发生,同时能降低对免疫功能的影响,预后良好。

Objective To investigate the effects of endovascular embolization and craniotomy on the clinical treatment effect and prognosis of cerebral aneurysms.Methods Fifty patients with cerebral aneurysm who were admitted to our hospital from January 2017 to June 2019 were selected as the research objects.They were divided into two groups according to the surgical method,namely,the embolization group and the clamping group,with 25 cases in each group.The patients in the embolization group were treated with endovascular interventional embolization.The patients in the clamping group were treated with craniotomy and the method of immunoturbidimetry was used to detect the serum immunoglobulin levels before and after operation in the two groups.Postoperative complications.A six-month follow-up was performed to evaluate the postoperative recovery of patients using the glasgow prognosis scale.Results After treatment,the serum immunoglobulin levels(IgG,IgA,and IgM)of the two groups of patients were significantly lower than before treatment,and the immunoglobulin levels of the patients in the pinch group were significantly lower than those in the embolization group(P<0.05);The incidence of complications in the group was significantly lower than that in the pinch group(P<0.05).After 6 months of follow-up,the Glasgow Prognostic Scale was used to evaluate the recovery of the patients.The excellent and good rate was 84.00%in the embolization group,which was significantly higher than 64.00%in the clamping group.Conclusion Intravascular interventional embolization for patients with cerebral aneurysm can significantly improve the patient's disease symptoms,reduce the incidence of postoperative complications,and reduce the impact on the patient's immune function.