开颅夹闭术和介入栓塞术对合并蛛网膜下腔出血患者治疗效果、认知功能及恢复情况的影响。
Effects of craniotomy clipping and interventional embolization on treatment efficacy, cognitive function and recovery of patients complicated with subarachnoid hemorrhage.
作者信息
Zhou Dezhong, Wei Didai, Xing Weizhou, Li Tinglong, Huang Yun
机构信息
Brain Center, Sanya People's Hospital Sanya 572000, Hainan Province, China.
出版信息
Am J Transl Res. 2021 May 15;13(5):5117-5126. eCollection 2021.
OBJECTIVE
This research was designed to investigate the effects of craniotomy clipping and interventional embolization (IE) on the treatment efficacy, cognitive function and recovery of patients with subarachnoid hemorrhage (SAH).
METHODS
A total of 148 patients with aneurysmal subarachnoid hemorrhage (ASAH) who underwent surgery in our hospital from December 2017 to August 2019 were included. They were divided into the clipping group (CG) (68 cases) and intervention group (IG) (80 cases) according to different surgical methods. The former received craniotomy clipping, and the latter underwent IE. The postoperative clinical indexes of patients were observed. The immune function (IgG, IgM, IgA) and inflammatory indexes (TNF-α, IL-8, HS-CRP) were detected before and after operation. The improvement of cognitive function, neurological function and sleep quality before and after operation was evaluated. Three months after operation, the treatment efficacy was evaluated and the postoperative complications were recorded.
RESULTS
The time of operation and hospitalization of patients in the IG were dramatically less than those in the CG (P < 0.05). The levels of IgG, IgM and IgA in the IG were higher than those in the CG after operation, while those of TNF-α, IL-8 and hs-CRP in the IG were lower than those in the CG. The MOCA scores of patients in the IG were obviously higher than those in the CG (P < 0.05), and the NIHSS and PSQI scores of patients in the IG were markedly lower than those in the CG. The total effective rate of patients in the IG was remarkably higher than that in the CG (P < 0.05), while the total incidence of postoperative complications in the IG was markedly lower than that in the CG.
CONCLUSION
IE is effective in the treatment of SAH patients, reducing the damage of immune, cognitive and nerve functions, with a high efficacy.
目的
本研究旨在探讨开颅夹闭术和介入栓塞术（IE）对蛛网膜下腔出血（SAH）患者治疗效果、认知功能及恢复情况的影响。
方法
纳入2017年12月至2019年8月在我院接受手术治疗的148例动脉瘤性蛛网膜下腔出血（ASAH）患者。根据不同手术方式将其分为夹闭组（CG）（68例）和干预组（IG）（80例）。前者接受开颅夹闭术，后者接受IE。观察患者术后临床指标。检测手术前后免疫功能（IgG、IgM、IgA）和炎症指标（TNF-α、IL-8、HS-CRP）。评估手术前后认知功能、神经功能及睡眠质量的改善情况。术后3个月评估治疗效果并记录术后并发症。
结果
IG患者的手术时间和住院时间显著短于CG患者（P<0.05）。术后IG患者的IgG、IgM和IgA水平高于CG患者，而IG患者的TNF-α、IL-8和hs-CRP水平低于CG患者。IG患者的MOCA评分明显高于CG患者（P<0.05），IG患者的NIHSS和PSQI评分明显低于CG患者。IG患者的总有效率显著高于CG患者（P<0.05），而IG患者术后并发症总发生率明显低于CG患者。
结论
IE治疗SAH患者有效，可减少免疫、认知和神经功能损伤，疗效较高。
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