微血管多普勒超声辅助颅内动脉瘤夹闭术患者脑血流动力学变化及神经功能的影响观察

Effectof microvascular doppler ultrasound assisted clipping on cerebral hemodynamics and nerve function in patients with intracranial aneurysms

目的探讨微血管多普勒超声(Microvascular disease,MVD)辅助颅内动脉瘤(Intracranial Aneurysm,ICA)夹闭术对患者脑血流动力学变化及神经功能的影响。方法选取2023年2月~2024年3月我院78例ICA患者,按照手术方法分为MVD组(n=39)与常规组(n=39)。常规组只行开颅夹闭术治疗,MVD组行MVD辅助下开颅颅内动脉瘤夹闭术治疗。比较两组手术效果、手术前后,应用美国国立卫生研究院卒中量表(NIHSS)、Baethel指数(BI)评分,通观察脑血流动力学指标(大脑前动脉血液流速、中动脉血液流速、脑脊液压力)变化、并发症发生情况进行对比。结果MVD组手术优良率94.87%比常规组79.49%高(P<0.05);术后1周,MVD组NIHSS评分较常规组低,BI评分较常规组高(P<0.05);术后1周,MVD组大脑前动脉血液流速、中动脉血液流速以及脑脊液压力较常规组低(P<0.05);MVD组并发症发生率5.13%比常规组20.51%低(P<0.05)。结论MVD辅助行ICA患者夹闭术治疗,可提高手术效果,改善脑血流动力学,促进神经功能恢复,安全性高。

Objective To observe the effects of microvascular Doppler ultrasound(MVD)assisted clipping on cerebral hemodynamics and nerve function in patients with intracranial aneurysm(ICA).Methods Seventy-eight patients with ICA in our hospital from February 2023 to March 2024 were selected and divided into MVD group(n=39)and conventional group(n=39)according to surgical methods.The conventional group was treated with craniotomy and the MVD group was treated with MVD assisted craniotomy.The surgical effect,National Institutes of Health Stroke Scale(NIHSS)score,Baethel index(BI),cerebral hemodynamic index(anterior cerebral artery blood flow rate,middle artery blood flow rate,cerebrospinal fluid pressure)and complications were compared between the two groups.Results The excellent and good rate of MVD group was 94.87%higher than that of conventional group 79.49%(P<0.05).The NIHSS score and BI index of MVD group were lower and higher than those of conventional group 1 week after operation(P<0.05).One week after surgery,the anterior cerebral artery blood flow velocity,middle artery blood flow velocity and cerebrospinal fluid pressure in MVD group were lower than those in conventional group(P<0.05).The complication rate of MVD group was 5.13%lower than that of conventional group 20.51%(P<0.05).Conclusion MVD-assisted clipping in the treatment of ICA patients can improve the surgical effect,improve cerebral hemodynamics,and promote the recovery of nerve function,with high safety.