血管内介入栓塞术联合腰椎穿刺脑脊液释放术治疗颅内动脉瘤的效果分析

Effect Effect of Intravascular Intervention Embolization Combined with Lumbar Puncture for Cerebrospinal Fluid Release in Treatment of Intracranial Aneurysm

目的:探讨血管内介入栓塞术联合腰椎穿刺脑脊液释放术治疗颅内动脉瘤的效果。方法:选取2020年5月—2022年5月济宁市第二人民医院收治的78例颅内动脉瘤患者作为研究对象,根据随机数字表法分为观察组与对照组,各39例。观察组给予血管内介入栓塞术联合腰椎穿刺脑脊液释放术治疗,对照组给予开颅夹闭术联合腰椎穿刺脑脊液释放术治疗。比较两组动脉瘤栓塞效果、氧化应激指标、血流动力学指标及并发症发生情况。结果:观察组完全栓塞率高于对照组,差异有统计学意义(P=0.039)。术后1周,观察组超氧化物歧化酶、丙二醛、基质金属蛋白酶-9、血清胱抑素-C水平优于对照组,差异有统计学意义(P<0.001)。阻断瘤体、术毕时,观察组平均动脉压、心率、颅内压、脑血流量水平均低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P=0.042)。结论:颅内动脉瘤患者实施血管内介入栓塞术联合腰椎穿刺脑脊液释放术可以提升动脉瘤的栓塞质量,抑制氧化应激反应,维持稳定的血流动力学,手术安全性较高。

Objective:To explore the effect of intravascular intervention embolization combined with lumbar puncture for cerebrospinal fluid release in treatment of intracranial aneurysm.Methods:A total of 78 patients with intracranial aneurysm who were admitted to Jining No.2 People's Hospital from May 2020 to May 2022 were selected as the study subjects.According to the random number table method,they were divided into observation group and control group,with 39 cases in each group.The observation group was treated with intravascular intervention embolization combined with lumbar puncture for cerebrospinal fluid release,and the control group was treated with craniotomy and clipping procedure combined with lumbar puncture for cerebrospinal fluid release.The effect of aneurysm embolization,oxidative stress indicators,hemodynamic indicators and complications were compared between the two groups.Results:The complete embolization rate in the observation group was higher than that in the control group,and the difference was statistically significant(P=0.039).At 1 week after surgery,the levels of superoxide dismutase,malondialdehyde,matrix metalloproteinase-9 and serum cystatin-C in the observation group were better than those in the control group,and the difference was statistically significant(P<0.001).During and after surgery,the mean arterial pressure,heart rate,intracranial pressure and cerebral blood flow levels in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P=0.042).Conclusion:Intravascular intervention embolization combined with lumbar puncture for cerebrospinal fluid release in patients with intracranial aneurysm can improve the embolization quality of aneurysm,inhibit oxidative stress reaction,maintain stable hemodynamics,and have high surgical safety.