[1]徐 兵,宣家龙,雍成明,等.早期血管内介入栓塞术对颅内动脉瘤破裂患者氧化应激反应及神经功能的影响[J].新乡医学院学报,2021,38(4):357-360.[doi:10.7683/xxyxyxb.2021.04.013]
 XU Bing,XUAN Jialong,YONG Chengming,et al.Effect of early endovascular embolization on the oxidative stress response and neurological function in patients with ruptured intracranial aneurysm[J].Journal of Xinxiang Medical University,2021,38(4):357-360.[doi:10.7683/xxyxyxb.2021.04.013]
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早期血管内介入栓塞术对颅内动脉瘤破裂患者氧化应激反应及神经功能的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年4
页码:
357-360
栏目:
临床研究
出版日期:
2021-04-05

文章信息/Info

Title:
Effect of early endovascular embolization on the oxidative stress response and neurological function in patients with ruptured intracranial aneurysm
作者:
徐 兵宣家龙雍成明杨代明黄录茂程志华
(安徽医科大学附属巢湖医院神经外科,安徽 巢湖 238000)
Author(s):
XU BingXUAN JialongYONG ChengmingYANG DaimingHUANG LumaoCHENG Zhihua
(Department of Neurosurgery,Chaohu Hospital Affiliated to Anhui Medical University,Chaohu 238000,Anhui Province,China)
关键词:
颅内动脉瘤破裂手术时机血管内介入栓塞术氧化应激反应神经功能
Keywords:
intracranial aneurysm rupturedoperative timingintravascular embolizationoxidative stress responseneurological function
分类号:
R743
DOI:
10.7683/xxyxyxb.2021.04.013
文献标志码:
A
摘要:
目的 探讨早期血管内介入栓塞术对颅内动脉瘤破裂患者氧化应激反应及神经功能的影响。方法 选择2016年1月至2020年5月安徽医科大学附属巢湖医院收治的58例颅内动脉瘤破裂患者为研究对象,所有患者行血管内介入栓塞术治疗,根据手术时机将患者分为观察组(n=30)和对照组(n=28),对照组患者于发病3 d后接受血管内介入栓塞术治疗,观察组患者于发病3 d内接受血管内介入栓塞术治疗。2组患者于术后第7天评估颅内动脉瘤栓塞情况;术前及术后第7天,采用美国国立卫生研究院卒中量表(NIHSS)评估患者神经功能缺损,采用改良Barthel 指数(MBI)评估患者的日常生活活动能力,采用紫外分光光度法检测血清丙二醛(MDA)、超氧化物歧化酶(SOD)水平;观察2组患者并发症发生情况。结果 观察组和对照组患者颅内动脉瘤完全栓塞率分别为73.33%(22/30)、39.29%(11/28),观察组患者颅内动脉瘤完全栓塞率显著高于对照组(Z=2.684,P<0.05)。2组患者术前NIHSS评分、MBI评分比较差异无统计学意义(P>0.05);与术前比较,2组患者术后第7天NIHSS评分显著降低,MBI评分显著升高(P<0.05);术后第7天,观察组患者NIHSS评分显著低于对照组,MBI评分显著高于对照组(P<0.05)。2组患者术前血清MDA、SOD水平比较差异无统计学意义(P>0.05);与术前比较,2组患者术后第7天血清MDA水平显著降低,SOD水平显著升高(P<0.05);术后第7天,观察组患者血清MDA水平显著低于对照组,SOD水平显著高于对照组(P<0.05)。观察组和对照组患者并发症发生率分别为3.33%(1/30)、25.00%(7/28),观察组患者并发症发生率显著低于对照组(χ2=5.718,P<0.05)。结论 早期血管内介入栓塞术可有效减轻颅内动脉瘤破裂患者氧化应激反应、神经功能缺损,提高完全栓塞率,降低并发症发生率。
Abstract:
Objective To investigate the effect of early endovascular embolization on the oxidative stress response and neurological function in patients with ruptured intracranial aneurysm.Methods  Fifty-eight patients with ruptured intracranial aneurysms admitted to Chaohu Hospital Affiliated to Anhui Medical University from January 2016 to May 2020 were selected as the research subjects,all patients underwent endovascular embolization,and the patients were divided into observation group (n=30) and control group (n=28) according to the operative timing.The patients in the control group received intravascular embolization after three days of onset,while the patients in the observation group received intravascular embolization within three days of onset.The results of embolization of intracranial aneurysms were evaluated on the seventh day after operation in the two groups.Before operation and seven days after operation,the neurologic impairment of patients was evaluated by the National Institute of Health stroke scale (NIHSS),and the activities of daily living of patients were evaluated by modified Barthel index (MBI),and the levels of serum malondialdehyde (MDA) and superoxide dismutase (SOD) were detected by ultraviolet spectrophotometry.The complications of patients in the two groups were observed.Results The complete embolization rate of intracranial aneurysms in the observation group and the control group was 73.33% (22/30) and 39.29% (11/28),respectively.The complete embolization rate of intracranial aneurysms in the observation group was significantly higher than that in the control group (Z=2.684,P<0.05).There was no significant difference in the NIHSS score and MBI score between the two groups before operation (P>0.05).Compared with before operation,the NIHSS score was significantly decreased,and the MBI score was significantly increased in the two groups on the seventh day after operation (P<0.05).On the seventh day after operation,the NIHSS score in the observation group was significantly lower than that in the control group,and the MBI score in the observation group was significantly higher than that in the control group (P<0.05).There was no significant difference in the levels of serum MDA and SOD between the two groups before operation (P>0.05).Compared with preoperation,the serum MDA level was significantly decreased and the SOD level was significantly increased in the two groups on the seventh day after operation (P<0.05).On the seventh day after operation,the serum MDA level in the observation group was significantly lower than that in the control group,and the SOD level in the observation group was significantly higher than that in the control group (P<0.05).The incidence of complications in the observation group and the control group was 3.33% (1/30) and 25.00% (7/28),respectively.The incidence of complications in the observation group was significantly lower than that in the control group (χ2=5.718,P<0.05).Conclusion The early endovascular embolization can effectively reduce the oxidative stress reaction and neurologic impairment,improve the complete embolization rate and reduce the incidence of complications in patients with ruptured intracranial aneurysms.

参考文献/References:

[1] KIM S H,KIM T G,KONG M H.A less invasive strategy for ruptured cerebral aneurysms with intracerebral hematomas:endovascular coil embolization followed by stereotactic aspiration of hematomas using urokinase[J].J Cerebrovasc Endovasc Neurosurg,2017,19(2):81-91.
[2] 朱海源.颅内破裂动脉瘤手术时机的研究进展[D].重庆:重庆医科大学,2014.
[3] 中华医学会神经外科学分会神经介入学组.颅内动脉瘤血管内介入治疗中国专家共识(2013)[J].中华医学杂志,2013,93(39):3093-3103.
[4] 苏优勒,张占普,窦长武,等.血管内介入栓塞与开颅手术夹闭治疗破裂颅内动脉瘤的疗效及安全性比较[J].疑难病杂志,2019,18(5):29-32,37.
[5] 叶子,张毅,虞昊,等.血管内介入栓塞术治疗脑动脉瘤的临床疗效及对Glasgow预后评分的影响[J].医学临床研究,2019,36(8):1554-1556.
[6] 马修尧,任超,王强,等.超早期和早期血管内介入治疗对Hunt-Hess高分级颅内动脉瘤破裂的安全性和有效性比较[J].中华全科医学,2018,16(3):356-359.
[7] 徐建,刘佰运.显微手术夹闭与血管内介入栓塞术治疗大脑中动脉动脉瘤破裂的临床疗效及安全性评价[J].临床和实验医学杂志,2018,17(16):1751-1754.
[8] RYU D S,SHIM Y S.Importance of hematoma removal ratio in ruptured middle cerebral artery aneurysm surgery with intrasylvian hematoma[J].J Cerebrovasc Endovasc Neurosurg,2017,19(1):5-11.
[9] 邓功建,冉娅娅,刘谊,等.血管内介入栓塞术对脑动脉瘤病人术后康复及血清TNF-α,sICAM-1水平的影响[J].中西医结合心脑血管病杂志,2019,17(21):3419-3422.
[10] 王志勇,朱耀祖,周有东,等.血管内微导管介入治疗与夹闭手术治疗脑动脉瘤的临床效果比较[J].检验医学与临床,2018,15(5):611-613,616.
[11] 胡新永,来海鸥,姬利,等.夹闭及栓塞治疗颅内动脉瘤对蛛网膜下腔出血患者脑血管痉挛及神经功能的影响[J].广西医科大学学报,2017,34(1):100-102.
[12] 蒋世杰,张波,方登富,等.不同手术时间介入栓塞对颅内动脉瘤临床疗效差异及影响预后相关因素分析[J].中国临床医生杂志,2017,45(11):52-55.
[13] IKAWA F,ABIKO M,ISHII D,et al.Effect of actual age on outcome at discharge in patients by surgical clipping and endovascular coiling for ruptured cerebral aneurysm in Japan[J].Neurosurg Rev,2018,41(4):1007-1011.
[14] 许志剑,余丹枫,周格知,等.开颅夹闭与介入栓塞治疗急性期破裂前交通动脉动脉瘤的临床比较[J].中国微侵袭神经外科杂志,2018,23(7):323-324.

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更新日期/Last Update: 2021-04-05