神经介入联合显微神经外科治疗动脉瘤性蛛网膜下腔出血对患者神经功能、预后情况及术后并发症发生情况的影响分析

Effect of Nerve Intervention Combined with Microsurgery in the Treatment of Aneurysmal Subarachnoid Hemorrhage on Neurological Function,Prognosis and Postoperative Complications

目的:探讨神经介入联合显微神经外科治疗动脉瘤性蛛网膜下腔出血对患者神经功能、预后情况及术后并发症发生情况的影响。方法:选取2019年3月~2021年4月收治的42例动脉瘤性蛛网膜下腔出血患者作为研讨对象,采用随机数字表法将其分为对照组(24例)和观察组(18例),对照组采用传统治疗方式,观察组接受神经介入联合显微神经外科方式治疗,比较两组患者神经功能、预后状况、并发症、血清炎性指标等。结果:两组患者术前GCS评分比较无统计学意义(t=0.1040,P>0.05);术后,观察组GOS评分高于对照组,差异有统计学意义(t=33.4652,P<0.05);比较两组患者预后状况,观察组中等残疾率66.67%高于对照组12.50%,病死率11.11%低于对照组41.67%,差异有统计学意义(P<0.05);重度残疾率11.11%、植物生存率11.11%比对照组20.83%、25%低,差异无统计学意义(χ2=0.7000、1.2868,P>0.05);观察组术后并发症发生率27.78%低于对照组62.50%,差异有统计学意义(χ2=4.9716,P<0.05);两组患者治疗前TNF-α(t=0.1781)、IL-6(t=0.0238)指标比较无意义(P>0.05),治疗后3d时,观察组TNF-α(t=47.9944)、IL-6(t=28.5163)低于对照组,差异有统计学意义(P<0.05)。结论:临床治疗动脉瘤性蛛网膜下腔出血可采用神经介入联合显微神经外科方式,在改善患者神经功能和疾病预后、控制并发症等方面效果理想,并可提升治疗疗效。

Objective:To investigate the effect of nerve intervention combined with microneurosurgery in the treatment of aneurysmal subarachnoid hemorrhage on neurological function,prognosis and postoperative complications.Methods:42 patients with aneurysmal subarachnoid hemorrhage treated from March 2019 to April 2021 were randomly divided into control group(24 cases)and observation group(18 cases).The control group was treated with traditional treatment,and the observation group was treated with nerve intervention combined with microneurosurgery.The neurological function,prognosis,complications and serum inflammatory indexes of the two groups were compared.Results:The preoperative GCS scores of the two groups were compared(t=0.1040,P>0.05);After operation,the GOS score of the observation group was higher than that of the control group(t=33.4652),the difference was statistically significant(P<0.05);The prognosis of the two groups was compared.The moderate disability rate in the observation group was 66.67%,which was higher than 12.50%in the control group,and the mortality rate was 11.11%lower than 41.67%in the control group(P<0.05);The severe disability rate of 11.11%and the plant survival rate of 11.11%were lower than those of the control group(20.83%and 25%),and the difference was not statistically significant(χ2=0.7000,1.2868,P>0.05);The incidence of postoperative complications in the observation group was 27.78%lower than that in the control group(62.50%),and the difference was statistically significant(χ2=4.9716,P<0.05);TNF before treatment in the two groups-α(t=0.1781)and IL-6(t=0.0238)(P>0.05).At 3 days after treatment,TNF in the observation group-α(t=47.9944)and IL-6(t=28.5163)were significantly lower than those in the control group(P<0.05).Conclusion:Nerve intervention combined with microsurgery can be used in the clinical treatment of aneurysmal subarachnoid hemorrhage.It has ideal effect in improving patients’neurological function,disease prognosis and controlling complications,and can improve the therapeutic effect.