介入栓塞术治疗老年脑动脉瘤性蛛网膜下腔出血患者的效果

Effects of interventional embolization in treatment of elderly patients with cerebral aneurysmal subarachnoid hemorrhage

目的:观察介入栓塞术治疗老年脑动脉瘤性蛛网膜下腔出血的效果。方法:选取2019年9月至2020年9月该院收治的80例老年脑动脉瘤性蛛网膜下腔出血患者进行前瞻性研究,按随机数字表法将其分为对照组(n=40)和研究组(n=40)。对照组给予开颅夹闭术治疗,研究组给予介入栓塞术治疗,比较两组手术前后炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平、T细胞亚群指标(CD4^(+)、CD3^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平,术后3个月预后情况和并发症发生率。结果:术后7 d,两组IL-6、TNF-α水平均高于术前,但研究组低于对照组,差异有统计学意义(P<0.05);术后7 d,两组CD3^(+)、CD8^(+)水平均高于术前,但研究组低于对照组,两组CD4^(+)、CD4^(+)/CD8^(+)水平均低于术前,但研究组高于对照组,差异有统计学意义(P<0.05);研究组预后分级优于对照组,差异有统计学意义(P<0.05);研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:介入栓塞术治疗老年脑动脉瘤性蛛网膜下腔出血患者可降低炎性因子水平和并发症发生率,改善T细胞亚群指标水平及预后,其效果优于开颅夹闭术治疗。

Objective:To observe effects of interventional embolization in treatment of senile cerebral aneurysmal subarachnoid hemorrhage.Methods:A prospective study was conducted on 80 elderly patients with cerebral aneurysmal subarachnoid hemorrhage admitted to the hospital from September 2019 to September 2020.They were divided into control group(n=40)and study group(n=40)according to the random number table method.The control group was treated with craniotomy clipping,while the study group was treated with interventional embolization.The levels of inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]and the T cell subset indexes(CD4^(+),CD3^(+),CD8^(+),CD4^(+)/CD8^(+))before and after the surgery,the good prognosis,and the incidence of complications 3 months after the surgery were compared between the two groups.Results:7 days after the surgery,the levels of IL-6 and TNF-αin the two groups were higher than those before the surgery,but those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).7 days after the surgery,the levels of CD3^(+)and CD8^(+)in the two groups were higher than those before the surgery,but those in the study group were lower than those in the control group;the levels of CD4^(+)and CD4^(+)/CD8^(+)in the two groups were lower than those before the surgery,but those in the study group were higher than those in the control group;and the difference was statistically significant(P<0.05).The prognosis grading of the study group was better than that of the control group,and the difference was statistically significant(P<0.05).Further,the incidence of complications in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusions:Interventional embolization in the treatment of the elderly patients with cerebral aneurysmal subarachnoid hemorrhage can reduce the levels of inflammatory factors and the incidence of complications,improve the levels of T cell subset indexes,and improve the prognosis.Moreover,it is superior to craniotomy clipping treatment.