LVIS密网支架辅助弹簧圈栓塞治疗颅内宽颈小动脉瘤的临床研究

Clinical study of intracranial wide-necked small aneurysms treated with LVIS dense mesh stent assisted coil embolization

目的探讨LVIS密网支架辅助弹簧圈栓塞治疗颅内宽颈小动脉瘤的临床效果,为患者诊疗提供依据。方法选择2018年12月至2019年11月期间梅州市中医医院神经外科收治的60例颅内宽颈小动脉瘤作为研究对象,采用简单随机数表法将其分为观察组和对照组各30例。对照组采用非支架辅助介入栓塞术治疗,观察组则采用LVIS密网支架辅助弹簧圈栓塞治疗。治疗结束时,比较术后两组患者的栓塞成功率,以及术前、术后神经功能缺损程度(NIHSS)评分、格拉斯哥昏迷(GCS)评分及生活质量(QOL)评分和并发症发生情况。结果观察组患者的栓塞成功率为93.33%,明显高于对照组的73.33%,差异有统计学意义(P<0.05);术后,两组患者的NIHSS评分均明显降低,且观察组为(1.52±0.31)分,明显低于对照组的(1.98±0.38)分,而GCS评分均明显升高,且观察组为(8.12±0.51)分,明显高于对照组的(6.59±1.13)分,差异均有统计学意义(P<0.05);术后,两组患者的躯体功能、社会功能、心理功能、生理功能评分均明显升高,且观察组[(81.12±5.44)分、(82.13±4.02)分、(79.74±6.02)分、(80.12±4.71)分]明显高于对照组[(72.16±5.02)分、(73.56±5.02)分、(70.13±5.79)分、(71.41±4.59)分],差异均有统计学意义(P<0.05);观察组患者术后并发症发生率为6.67%,明显低于对照组的26.67%,差异有统计学意义(P<0.05)。结论LVIS密网支架辅助弹簧圈栓塞治疗颅内宽颈小动脉瘤可有效恢复患者的神经功能,提高生活质量,临床治疗效果显著,安全性较好,值得临床推广使用。

Objective To explore the clinical effect of LVIS dense mesh stent assisted coil embolization in the treatment of intracranial wide-necked small aneurysms,and provide basis for the diagnosis and treatment of patients.Methods A total of 60 patients with intracranial wide-necked small aneurysms treated in Department of Neurosurgery,Meizhou Hospital of Traditional Chinese Medicine from December 2018 to November 2019 were selected as the research objects.They were divided into an observation group and control group by simple random number table method,with 30 patients in each group.The control group was treated with non-stent assisted interventional embolization,while the observation group was treated with LVIS dense mesh stent assisted coil embolization.At the end of treatment,the success rate of embolization,National Institute of Health stroke scale(NIHSS)score,Glasgow coma scale(GCS),Quality of Life(QOL)score and complications were compared before and after operation between the two groups.Results The success rate of embolization in the observation group was 93.33%,which was significantly higher than 73.33%in the control group(P<0.05).After operation,the NIHSS scores between the two groups were significantly reduced,and the score in the observation group of(1.52±0.31)points was significantly lower than the control group(1.98±0.38)points.The GCS scores were significantly increased,and the score in the observation group of(8.12±0.51)points was significantly higher than that in the control group(6.59±1.13)points,P<0.05.After surgery,the scores of physical function,social function,psychological function,and physiological function between the two groups of patients were significantly increased,and the scores in the observation group were(81.12±5.44)points,(82.13±4.02)points,(79.74±6.02)points,(80.12±4.71)points,which were significantly higher than(72.16±5.02)points,(73.56±5.02)points,(70.13±5.79)points,(71.41±4.59)points in the control group,P<0.05.The complication rate in the observation group was 6.67%,which was significantly lower than were 26.67%in the control group(P<0.05).Conclusion LVIS dense mesh stent assisted coil embolization for the treatment of intracranial wide-necked small aneurysms can effectively restore the patient’s neurological function,improve the quality of life.The clinical treatment effect is significant,with have good safety.It is worthy of clinical application.