施阳

[摘要] 目的 研究分析早期介入栓塞治疗脑动脉瘤破裂的疗效及安全性。方法 2014年8月—2016年8月期间，方便选择该院接收的脑动脉瘤破裂患者92例作为研究对象，将92例患者随机分为两组，观察组46例和对照组46例，其中，对照组患者在入院3 d后进行介入栓塞治疗，观察组患者在入院3 d内进行介入栓塞治疗，评级观察组、对照组患者介入栓塞治疗效果，对患者完全、次完全以及不完全栓塞率进行观察，并记录患者并发症发生情况，应用Rankin评分量表和改良Barthel评分量表对患者预后情况进行评价，并进行对比研究，以分析早期介入栓塞治疗的应用价值。结果 观察组患者完全栓塞率84.78%、次完全栓塞率13.04%以及不完全栓塞率2.17%与对照組患者差异有统计学意义（P<0.05）；观察组患者Rankin评分（1.20±0.13）分比对照组低，改良Barthel评分（97.58±2.11）分比对照组高，差异有统计学意义（P<0.05）；观察组患者脑积水2.17%、脑血管痉挛2.17%、动脉瘤再次破裂2.17%、蛛网膜下腔出血4.35%、复发率2.17%与对照组比较差异有统计学意义（P<0.05）。结论 早期介入栓塞治疗脑动脉瘤破裂的疗效较理想，能有效改善患者预后，且安全性较高，值得推广应用。

[关键词] 早期介入栓塞；脑动脉瘤；破裂；疗效

[中图分类号] R651 [文献标识码] A [文章编号] 1674-0742（2017）07（a）-0020-03

Curative Effect and Safety of Early Interventional Aneurysm Embolization in Treatment of Rupture of Cerebral Aneurysm

SHI Yang

Department of Neurosurgery， Jilin Chinese and Western Union Hospital， Jilin， Jilin Province， 132012 China

[Abstract] Objective To research and analyze the curative effect and safety of early interventional aneurysm embolization in treatment of rupture of cerebral aneurysm. Methods Convenient selection 92 cases of patients with rupture of cerebral aneurysm admitted and treated in our hospital from August 2014 to August 2016 were selected and randomly divided into two groups with 46 cases in each， the control group adopted the interventional aneurysm embolization after 3 d admission， and the observation group adopted the interventional aneurysm embolization in 3 d after admission， and the effect of the two groups was evaluated and the complete， sub-complete and incomplete embolization rates of patients were observed and the occurrence of complications was recorded and the prognosis was evaluated by the Rankin scale and modified Barthel scale thus analyzing the application value of early interventional aneurysm embolization. Results The complete， sub-complete and incomplete embolization rates in the observation group were respectively 84.78%， 13.04% and 2.17%， and the differences were statistically significant（P<0.05）， and the Rankin score was lower than that in the control group， which was （1.20±0.13）points in the observation group， and the modified Barthel score was （97.58±2.11）points， which was higher than that in the control group， and the differences were statistically significant（P<0.05）， and the incidence rates of hydrocephalus， cerebral angiospasm， second aneurysm rupture， subarachnoid hemorrhage and recurrence rate in the observation group were respectively 2.17%， 2.17%， 2.17%， 4.35% and 2.17%， and the differences between the two groups were statistically significant（P<0.05）. Conclusion The curative effect of early interventional aneurysm embolization in treatment of rupture of cerebral aneurysm is ideal， which can effectively improve the prognosis of patients with high safety， and it is worth promotion and application.endprint

[Key words] Early interventional aneurysm embolization； Cerebral aneurysm； Rupture； Curative effect

脑动脉瘤破裂会严重影响患者身体健康和生命安全，致残率和死亡率均较高[1]。相关研究指出，脑动脉瘤破裂致残率约为50%，致死率约为30%～40%[2]。以往临床上通常采用手术夹闭方法来治疗该病，而随着医学的进步，临床上已经广泛应用介入栓塞方法来对该病患者进行治疗，且成为脑动脉瘤破裂患者治疗的重要方法[3-4]。介入栓塞治疗方法无需进行开颅手术，对患者损伤程度较低，能促进患者尽快恢复，获得了广大医学工作者和患者的认可[5]。但是在开展介入栓塞治疗时机方面，仍存在不同的看法。该院为了进一步了解早期介入栓塞治疗以及晚期介入栓塞治疗的效果，方便抽取2014年8月—2016年8月期间入院治疗的92例脑动脉瘤破裂患者作为研究对象，取得了良好成果，现报道如下。……