| 孙 伟,黄冠敏,刘 园,路 飞,顾 锐.颅内介入栓塞术与颅内夹闭术对高分级动脉瘤性蛛网膜下腔出血患者神经功能、免疫状态及睡眠质量的影响[J].,2020,(18):3524-3527 |
| 颅内介入栓塞术与颅内夹闭术对高分级动脉瘤性蛛网膜下腔出血患者神经功能、免疫状态及睡眠质量的影响 |
| Effects of Intracranial Interventional Embolization and Intracranial Clipping on Neurologic Function, Immune Status and Sleep Quality of Patients with High Grade Aneurysmal Subarachnoid Hemorrhage |
| 投稿时间：2020-02-03 修订日期：2020-02-28 |
| DOI：10.13241/j.cnki.pmb.2020.18.028 |
| 中文关键词: 颅内介入栓塞术 颅内夹闭术 动脉瘤性蛛网膜下腔出血 |
| 英文关键词: Intracranial interventional embolization Intracranial clipping Aneurysmal subarachnoid hemorrhage |
| 基金项目:安徽省卫生计生委科研计划项目（2016qk1108）；淮南市科技计划项目（2018B55） |
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| 中文摘要: |
| 摘要 目的：比较颅内介入栓塞术与颅内夹闭术对高分级动脉瘤性蛛网膜下腔出血（aSAH）患者神经功能、免疫状态及睡眠质量的影响。方法：回顾性分析我院自2015年1月到2019年8月收治的高分级aSAH患者80例的临床资料，根据手术方式的不同将患者分为A组（n=38，颅内夹闭术）和B组（n=42，颅内介入栓塞术），比较两组患者疗效、神经功能、免疫状态、睡眠质量及并发症发生情况。结果：B组的预后良好率为73.81%（31/42），高于A组的60.53%（23/38）（P<0.05）。两组患者术后3个月美国国立卫生研究所卒中量表（NIHSS）、匹兹堡睡眠质量指数量表（PSQI ）评分均降低，且B组低于A组（P<0.05）。两组患者术后1d、术后5d免疫球蛋白（Ig）G、IgA 及 IgM均呈先下降后升高趋势，B组术后1d、术后5d IgG、IgA 及 IgM均高于A组（P<0.05）。B组的术后并发症发生率为11.90%（5/42），低于A组的31.58%（12/38）（P<0.05）。结论：颅内介入栓塞术应用于高分级aSAH患者的疗效优于颅内夹闭术，并且可以改善患者的神经功能、睡眠质量，减少并发症发生风险，减轻免疫抑制。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the effects of intracranial interventional embolization and intracranial clipping on neurological function, immune status and sleep quality in patients with high-grade aneurysmal subarachnoid hemorrhage (aSAH). Methods: The clinical data of 80 patients with high-grade aSAH who were admitted to our hospital from January 2015 to August 2019 were analyzed retrospectively. According to the different operation methods, the patients were divided into group A (n = 38, intracranial clipping) and group B (n = 42, intracranial interventional embolization). The curative effect, neurological function, immune status, sleep quality and complications of the two groups were compared. Results: The good prognosis rate of group B was 73.81% (31/42), which was higher than 60.53% (23/38) of group A (P < 0.05). The scores of national Institutes of Health Stroke Scale (NIHSS), pittsburgh sleep quality index (PSQI) in the two groups were decreased, and the group B was lower than that in group A (P < 0.05). The levels of immunoglobulin（Ig）G, IgA and IgM in group B were decreased first and then increased at 1d after operation, 5d after operation, IgG, IgA and IgM in group B were higher than those in group A at 1d after operation, 5d after operation (P< 0.05). The incidence of postoperative complications in group B was 11.90% (5/42), which was lower than 31.58% (12/38) in group A (P < 0.05). Conclusion: Intracranial interventional embolization is superior to intracranial clipping in the treatment of high-grade aSAH, and it can improve the neurological function, sleep quality, reduce the risk of complications and immune suppression. |
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