介入栓塞和开颅夹闭治疗WFNS IV级动脉瘤性蛛网膜下腔出血患者的预后分析

doi:10.19854/j.cnki.1008-2425.2023.05.0004

摘要/Abstract

摘要： 目的探讨介入栓塞和开颅夹闭治疗WFNSIV级动脉瘤性蛛网膜下腔出血患者的预后。方法收集自2020年6月至2023年6月中国科学技术大学附属第一医院神经外科收治的70例WFNSIV级的动脉瘤性蛛网膜下腔出血患者的临床资料,根据手术方式不同将患者分为介入栓塞组和开颅夹闭组,对比分析两组患者的住院时间,再出血、脑梗死、脑积水、深静脉血栓、颅内感染、肺炎、认知障碍、血管痉挛等的发生率及术后3个月的GOS评分等的差异。结果共纳入患者70例,其中介入栓塞组39例,开颅夹闭组31例;两组患者在住院时间,再出血、脑梗死、脑积水、深静脉血栓、颅内感染发生率之间的差异无统计学意义(P＞0.05);术后肺炎、认知障碍、血管痉挛之间的发生率差异存在统计学意义(P＜0.05);术后3个月的GOS 5级组的比例,介入栓塞组高于开颅夹闭组,两者之间差异存在统计学意义(P＜0.05)。结论对于WFNS IV级的动脉瘤性蛛网膜下腔出血患者采用血管内介入栓塞治疗在围手术期并发症及预后优于开颅夹闭治疗。

关键词: WFNS分级, 介入栓塞, 显微夹闭, 预后

Abstract: Objective To investigate the prognosis of patients with WFNS grade IV aneurysmal subarachnoid hemorrhage treated by interventional embolization and craniotomy clamp.Methods Collect clinical data of 70 patients with WFNS grade IV aneurysmal subarachnoid hemorrhage admitted to the Neurosurgery Department of the First Affiliated Hospital of the University of Science and Technology of China from June 2020 to June 2023.According to different surgical methods,the patients were divided into intervention embolization group and craniotomy clamp group.Compare and analyze the hospitalization time of the two groups of patients,including recurrent bleeding,cerebral infarction,hydrocephalus,deep vein thrombosis,intracranial infection,pneumonia,cognitive impairment Differences in the incidence of vasospasm and GOS scores at 3 months after surgery.Results A total of 70 patients were included,including 39 in the interventional embolization group and 31 in the craniotomy clamp group; There was no statistically significant difference (P>0.05) between the two groups of patients in terms of hospital stay,incidence of rebleeding,cerebral infarction,hydrocephalus,deep vein thrombosis,and intracranial infection; There was a statistically significant difference in the incidence of postoperative pneumonia,cognitive impairment,and vasospasm (P＜0.05); The proportion of GOS grade 5 group at 3 months after surgery was higher in the interventional embolization group than in the craniotomy clamp group,and there was a statistically significant difference between the two groups (P＜0.05).Conclusion For patients with WFNS grade IV aneurysmal subarachnoid hemorrhage,endovascular embolization is superior to craniotomy clipping therapy in terms of perioperative complications and prognosis.

Key words: WFNS grade, Interventional embolization, Microscopy clipping, Prognosis

中图分类号:

R732.2⁺1

刘运培, 武银刚, 高歌. 介入栓塞和开颅夹闭治疗WFNS IV级动脉瘤性蛛网膜下腔出血患者的预后分析[J]. 立体定向和功能性神经外科杂志, 2023, 36(5): 274-277.

Liu Yunpei, Wu Yingang, Gao Ge. Prognostic analysis of interventional embolization and craniotomy clipping treatment for WFNS grade IV aneurysmal subarachnoid hemorrhage patients[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2023, 36(5): 274-277.

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