加速康复外科干预在颅内破裂动脉瘤Lvis支架辅助弹簧圈血管内栓塞中的临床价值分析

Clinical value of enhanced recovery after surgery intervention in endovascular embolization of ruptured intracranial aneurysms assisted by Lvis stent

目的分析加速康复外科(enhanced recovery after surgery,ERAS)干预在颅内破裂动脉瘤Lvis支架辅助弹簧圈血管内栓塞中的临床价值。方法选取2015年3月至2020年3月江苏省人民医院收治的94例颅内破裂动脉瘤患者为研究对象,采用随机数字表法将其分为ERAS干预组和常规干预组,每组各47例,均行Lvis支架辅助弹簧圈内血管栓塞治疗,常规干预组患者围术期接受常规干预,ERAS干预组患者接受基于ERAS理念的围术期干预。比较两组患者栓塞情况、恢复情况、术后并发症发生率和预后。结果两组患者完全栓塞率比较差异无统计学意义(P>0.05)。ERAS干预组患者症状消失时间、住院天数均显著短于常规干预组(均P<0.05),出院时格拉斯哥预后量表评分显著高于常规干预组(P<0.05),术后并发症发生率显著低于常规干预组(P<0.05)。两组患者术后6个月改良Rankin量表(modified Rankin scale,mRS)评分均显著低于本组术前(均P<0.05),ERAS干预组患者术后6个月mRS评分显著低于常规干预组(P<0.05),术后6个月恢复良好率显著高于常规干预组(P<0.05)。结论ERAS干预能够在保证颅内破裂动脉瘤Lvis支架辅助弹簧圈血管内栓塞效果的前提下提高治疗安全性,缩短术后恢复时间,改善患者近期预后。

Objective To analyze the clinical value of enhanced recovery after surgery(ERAS)intervention in endovascular embolization of ruptured intracranial aneurysms assisted by Lvis stent.Method From March 2015 to March 2020,94 patients with ruptured intracranial aneurysms in Jiangsu Province Hospital were selected and randomly divided into ERAS intervention group and conventional intervention group,with 47 cases in each group.All patients were treated with Lvis stent assisted coil embolization.Conventional intervention group patients were received routine perioperative intervention,and ERAS intervention group patients were received perioperative intervention based on ERAS intervention.The situation of embolism,recovery,incidence of postoperative complications and prognosis were compared between the two groups.Result There was no significant of complete embolism rate between the two groups(P>0.05).The symptom disappearance time and hospital days of patients in ERAS intervention group were significantly shorter than those in conventional intervention group(all P<0.05),the Glasgow outcome scale score at discharge was significantly higher than that in conventional intervention group(P<0.05),the incidence of postoperative complications was significantly lower than that in conventional intervention group(P<0.05).The modified Rankin scale(mRS)scores in the two groups at 6 months after surgery were significantly lower than those before surgery in the same group(all P<0.05).The mRS score in ERAS intervention group at 6 months after surgery was significantly lower than that in conventional intervention group(P<0.05),the good recovery rate at 6 months after surgery was significantly higher than that in conventional intervention group(P<0.05).Conclusion ERAS can improve the safety of treatment,shorten the recovery time and improve the short-term prognosis of patients with ruptured intracranial aneurysms on the premise of ensuring the effect of Lvis stent assisted coil endovascular embolization.