【摘要】 目的比较介入栓塞术与手术夹闭法治疗动脉瘤性蛛网膜下腔出血(a SAH)的临床效果。方法选取绵竹市人民医院2010年8月—2015年2月收治的a SAH患者62例,随机分为对照组30例和观察组32例。观察组患者采用介入栓塞术治疗,对照组患者采用手术夹闭法治疗。比较两组短期预后及并发症发生率,术前及术后第1、3天免疫功能指标(IgG、IgM及IgA),手术前后血清类胰岛素一号生长因子(IGF-1)、可溶性细胞间黏附分子-1(s ICAM-1)及可溶性血管细胞黏附分子-1(s VCAM-1)水平。结果观察组患者短期预后优于对照组(u=-1.754,P=0.040)。术前两组患者IgG、IgM及IgA水平比较,差异无统计学意义(P>0.05);术后第1、3天观察组患者IgG、IgM及IgA水平均高于对照组(P<0.05)。术前两组患者血清IGF-1、s ICAM-1及s VCAM-1水平比较,差异无统计学意义(P>0.05);术后观察组患者血清IGF-1、sICAM-1及sVCAM-1水平低于对照组(P<0.05)。观察组患者术后并发症发生率为18.8%,低于对照组的50.0%(P<0.05)。结论与手术夹闭法相比,介入栓塞术治疗a SAH的临床效果更佳,对患者免疫功能影响较小。更多还原

【Abstract】 Objective To compare the clinical effect on aneurysmal subarachnoid hemorrhage between interventional embolization and surgical clipping therapy. Methods A total of 62 patients with aneurysmal subarachnoid hemorrhage were selected in the People’s Hospital of Mianzhu from August 2010 to February 2015,and they were randomly divided into control group( n = 30) and observation group( n = 32). Patients of control group received surgical clipping therapy,while patients of observation group received interventional embolization. Short- term prognosis,incidence of complications,immunologic function index( including serum levels of Ig G,Ig M and Ig A) before surgery and on the first,third day of surgery, serum levels of IGF-1,s ICAM-1 and s VCAM-1 before and after surgery were compared between the two groups. Results The short- term prognosis of observation group was statistically significantly better than that of control group( u =- 1. 754,P = 0. 040). No statistically significant differences of serum level of Ig G,Ig M or Ig A was found between the two groups before surgery( P >0. 05),while serum levels of Ig G,Ig M and Ig A of observation group were statistically significantly higher than those of control group on the first and third day of surgery( P < 0. 05). No statistically significant differences of serum level of IGF-1,s ICAM-1or s VCAM-1 was found between the two groups before surgery( P > 0. 05),while serum levels of IGF-1,s ICAM-1 and s VCAM-1of observation group were statistically significantly lower than those of control group after surgery. The incidence of complications of observation group was 18. 8%,was statistically significantly lower than that of control group of 50. 0%( P < 0. 05). Conclusion Compared with surgical clipping therapy,interventional embolization has better clinical effect and less impact on immunologic function in treating patients with aneurysmal subarachnoid hemorrhage.更多还原