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颅内破裂动脉瘤的血管内栓塞治疗:疗效及对氧化应激水平的影响

Endovascular embolization for ruptured intracranial aneurysms: efficacy and effects on oxidative stress levels.

作者信息

Yang Sheng, Wu Shanwu, Ouyang Guang

机构信息

Department of Neurosurgery, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan , Hubei Province, 442000, China.

Department of Neurosurgery, Puren Hospital Affiliated to Wuhan University of Science and Technology Qingshan District, No. 1, Benxi Street, Wuhan Hubei Province, 430081, China.

出版信息

Perioper Med (Lond). 2025 Sep 2;14(1):93. doi: 10.1186/s13741-025-00577-x.

DOI:10.1186/s13741-025-00577-x
PMID:40898296
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12406379/
Abstract

OBJECTIVE

This study aimed to investigate the efficacy of endovascular embolization in treating ruptured intracranial aneurysms (RIAs).

METHODS

RIA patients (n = 89) were grouped according to different surgical methods. The control group (n = 42) received aneurysm clipping surgery, whereas the observation group (n = 47) received endovascular embolization. The National Institutes of Health Stroke Scale (NIHSS) was used to assess neurological function pre-treatment and at 7 days post-treatment. Oxidative stress status, including superoxide dismutase (SOD) levels and serum malondialdehyde (MDA) levels, was compared between the two groups pre-treatment and at 7 days post-treatment. Intraoperative bleeding, operative time, and hospitalization time were compared between the two groups. Vascular endothelial function, including von Willebrand factor (vWF), endothelin-1 (ET-1), and nitric oxide (NO), was evaluated pre-treatment and 3 months post-treatment. Postoperative complications and surgical outcomes were observed.

RESULTS

After treatment, compared to the control group, the observation group had lower NIHSS scores, higher SOD levels, and lower MDA levels, with statistically significant differences (all P < 0.001); the observation group also had less intraoperative bleeding, shorter operation times, and shorter hospital stays, along with lower vWF and ET-1 levels, higher NO levels, and statistically significant differences (all P < 0.001). The incidence of postoperative complications was lower in the observation group, with a statistically significant difference (P = 0.048). The therapeutic effect was better in the observation group, with a statistically significant difference (P = 0.041).

CONCLUSION

Compared with microscopic aneurysm clipping, endovascular embolization offers better efficacy for patients with RIA and causes less vascular endothelial damage.

摘要

目的

本研究旨在探讨血管内栓塞治疗破裂颅内动脉瘤(RIAs)的疗效。

方法

将89例RIA患者根据不同手术方法分组。对照组(n = 42)接受动脉瘤夹闭手术,而观察组(n = 47)接受血管内栓塞治疗。采用美国国立卫生研究院卒中量表(NIHSS)在治疗前和治疗后7天评估神经功能。比较两组治疗前和治疗后7天的氧化应激状态,包括超氧化物歧化酶(SOD)水平和血清丙二醛(MDA)水平。比较两组的术中出血量、手术时间和住院时间。在治疗前和治疗后3个月评估血管内皮功能,包括血管性血友病因子(vWF)、内皮素-1(ET-1)和一氧化氮(NO)。观察术后并发症和手术结果。

结果

治疗后,与对照组相比,观察组NIHSS评分更低,SOD水平更高,MDA水平更低,差异有统计学意义(均P < 0.001);观察组术中出血量更少,手术时间更短,住院时间更短,vWF和ET-1水平更低,NO水平更高,差异有统计学意义(均P < 0.001)。观察组术后并发症发生率更低,差异有统计学意义(P = 0.048)。观察组治疗效果更好,差异有统计学意义(P = 0.041)。

结论

与显微镜下动脉瘤夹闭术相比,血管内栓塞治疗对RIA患者疗效更好,对血管内皮的损伤更小。