不同时机行血管介入栓塞术对颅内动脉瘤病人认知功能的影响

Effect of the vascular interventional embolization at different time on cognitive function of patients with intracranial aneurysm

目的:探讨不同时机行血管介入栓塞术治疗对颅内动脉瘤病人的临床疗效及认知功能的影响。方法:63例颅内破裂动脉瘤病人,根据手术时机的不同分为早期介入组34例和延期介入组29例。对2组病人手术前后的蒙特利尔认知评估(MoCA)量表评分、术后即刻栓塞率,并发症发生率以及随访3个月的GOS评估结果进行比较、分析。结果:术后早期介入组病人完全栓塞率高于延期介入组(P<0.05);2组术后各时间点MoCA量表评分均低于术前(P<0.05),其中早期介入组病人的术后MoCA量表评分均高于延期介入组(P<0.05);早期介入组病人的术后并发症发生率低于延期介入组(P<0.05)。术后随访3个月的GOS评估结果显示,早期介入组病人恢复情况优于延期介入组(P<0.05)。结论:早期行血管介入栓塞术对颅内破裂动脉瘤病人的临床疗效及预后改善情况效果明显,且能够更有效地改善病人术后的认知功能,有利于病人的恢复,值得临床参考推广。

Objective:To investigate the effects of the vascular interventional embolization therapy at different time on the clinical effects and cognitive function of the patients with intracranial aneurysms.Methods:The clinical data of 63 patients with intracranial ruptured aneurysms were retrospectively analyzed,and the patients were divided into the early group(34 cases)and delayed group(29 cases)according to different operative opportunity.The Montreal cognitive assessment(MoCA)scale scores before and after operation,postoperative immediate embolization rate,incidence rate of complications,and GOS evaluation results after 3 months of postoperative following up were compared between two groups.Results:After operation,the complete embolism rate in early group was significantly higher than that in delayed group(P<0.05).The scores of MoCA scale in two groups at all time points were lower than those before surgery(P<0.05),and the scores of MoCA scale in early group were higher than those in delayed group(P<0.05).The incidence rate of postoperative complications in early group was significantly lower than that in delayed group(P<0.05).The results of GOS evaluation after 3 months of postoperative following up showed that the recovery of patients in early group was better than that in delayed group(P<0.05).Conclusions:Early vascular interventional embolization therapy can significantly improve the clinical efficacy and prognosis of patients with intracranial ruptured aneurysms,and more effectively improve the postoperative cognitive function.It is conducive to the recovery of patients,and worthy of clinical reference and promotion.