高压氧联合脑室镜辅助颅内动脉瘤夹闭术治疗脑动脉瘤的疗效分析

Analysis of therapeutic effect of hyperbaric oxygen combined with ventriculoscope-assisted intracranial aneurysm clipping in cerebral aneurysms

目的:探讨脑室镜辅助颅内动脉瘤夹闭术联合高压氧对早期脑动脉瘤患者术后血清基质金属蛋白酶-9(MMP-9)、可溶性细胞间黏附分子-1(sICAM-1)水平变化及生活质量的影响。方法:选取2015年4月至2017年1月我院84例早期脑动脉瘤患者,随机数字表法分为对照组(n=42)与研究组(n=42)。常规治疗基础上对照组采取脑室镜辅助颅内动脉瘤夹闭术,研究组采取脑室镜辅助颅内动脉瘤夹闭术+高压氧治疗(治疗10次)。6个月后进行随访,统计对比入院时及末次随访时两组生活质量(SF-36)及日常生活能力(ADL)分值、入院时及治疗结束后第2 d血清MMP-9及sICAM-1水平、并发症发生率、预后效果。结果:治疗后两组SF-36及ADL分值较治疗前增高,且研究组较对照组高,差异有统计学意义(P<0.05);治疗后两组血清MMP-9及sICAM-1水平较治疗前降低,且研究组较对照组低,差异有统计学意义(P<0.05);研究组并发症发生率(7.14%)较对照组(19.05%)低,但差异无统计学意义(P>0.05);研究组预后情况优于对照组,差异有统计学意义(P<0.05)。结论:联合采用脑室镜辅助颅内动脉瘤夹闭术及高压氧治疗早期动脉瘤效果显著,可降低血清MMP-9、sICAM-1水平,提高患者日常生活能力及生活质量,改善预后效果,且可降低并发症发生率。

Objective:To investigate the effect of hyperbaric oxygenation combined with endoscopic assisted clipping of intracranial aneurysm on the changes of serum MMP-9 and sICAM-1 levels and quality of life in patients with early cerebral aneurysms.Methods:84 patients with early cerebral aneurysm from April 2015 to January 2017 in our hospital were randomly divided into the control group(n=42)and the study group(n=42).On the basis of conventional treatment,the control group was treated with endoscopic assisted clipping of intracranial aneurysm,and the study group was treated with hyperbaric oxygenation combined with endoscopic assisted clipping of intracranial aneurysm.Each group treated for 10 times.Follow up after 6 months.Make statistical comparison of quality of life(SF-36)and the ability of daily life(ADL)score of the two groups on admission and at the last follow-up,serum MMP-9 and sICAM-1 levels and the incidence of complications and prognosis at the end of admission and second day after treatment.Results:After treatment,the scores of SF-36 and ADL in two groups were higher than before treatment,and the study group was higher than that of the control group(P<0.05).After treatment,the serum MMP-9 and sICAM-1 levels of the two groups were lower than before treatment,and the study group was lower than the control group(P<0.05).The incidence of complications in the study group(7.14%)was lower than that in the control group(19.05%),but the difference was statistically insignificant(P>0.05).The prognosis of the study group was better than that of the control group(P<0.05).Conclusion:Hyperbaric oxygenation combined with endoscopic assisted clipping of intracranial aneurysm on treating early cerebral aneurysms has got remarkable effect.It can reduce the serum levels of MMP-9 and sICAM-1,improve the daily living ability and quality of life,improve the prognosis,and reduce the incidence of complications.