早期侧脑室引流联合动脉瘤介入栓塞术治疗动脉瘤性蛛网膜下腔出血的效果及对sICAM-1、Caspase-3的影响

Effect of early lateral ventricle drainage combined with aneurysm interventional embolization in the treatment of aneurysmal subarachnoid hemorrhage and its influences on sICAM-1 and Caspase-3

目的探讨早期侧脑室引流联合动脉瘤介入栓塞术治疗动脉瘤性蛛网膜下腔出血(aSAH)的效果。方法选择2017年1月至2021年12月接收的100例aSAH患者为研究对象,根据治疗方案不同将其分为对照组和观察组,各50例。对照组接受动脉瘤介入栓塞术治疗,观察组在对照组基础上加施早期侧脑室引流。比较两组的治疗效果。结果观察组的治疗总有效率高于对照组(P<0.05)。术后7 d,观察组的可溶性细胞间黏附分子-1(sICAM-1)、半胱氨酸天冬氨酸蛋白酶-3(Caspase-3)水平均低于对照组(P<0.05)。术后7 d,观察组的最小血流速度(Vmin)、动态阻力(DR)高于对照组,外周阻力(RV)、脉搏波速度(Wv)低于对照组(P<0.05)。观察组的并发症总发生率低于对照组(P<0.05)。结论早期侧脑室引流联合动脉瘤介入栓塞术治疗aSAH可改善患者的脑部血流动力学,调节sICAM-1、Caspase-3水平,降低并发症发生率,提升整体疗效,值得推广。

Objective To explore the effect of early lateral ventricle drainage combined with aneurysm interventional embolization in the treatment of aneurysmal subarachnoid hemorrhage(aSAH).Methods A total of 100 patients with aSAH received from January 2017 to December 2021 were selected as the research objects.According to different treatment plan,the patients were divided into control group and observation group,with 50 cases in each group.The control group was treated with aneurysm interventional embolization,and the observation group was treated with early lateral ventricle drainage on the basis of the control group.The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).At 7 d after operation,the levels of soluble intercellular adhesion molecule-1(sICAM-1)and cysteinyl aspartate specific proteinase-3(Caspase-3)in the observation group were lower than those in the control group(P<0.05).At 7 d after operation,the minimum blood flow velocity(Vmin)and dynamic resistance(DR)in the observation group were higher than those in the control group,and the vascular resistance(RV)and pulse wave velocity(Wv)were lower than those in the control group(P<0.05).The total incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion Early lateral ventricle drainage combined with aneurysm interventional embolization in the treatment of aSAH can improve the cerebral hemodynamics of patients,regulate the levels of sICAM-1 and Caspase-3,reduce the incidence of complications,and improve the overall efficacy,which is worthy of promotion.