【摘要】 目的 探讨脑动脉瘤破裂出血患者血管介入栓塞术治疗时机对其疗效及近远期预后的影响。方法 选取2021年4月至2024年4月，东台市人民医院收治的91例脑动脉瘤破裂出血患者的临床资料。患者均采用血管介入栓塞术治疗，根据治疗时机不同分为对照组（发病24 h后治疗，n=43）和研究组（发病24 h内治疗，n=48）。比较两组患者的临床疗效、并发症发生率、炎症因子[白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、基质金属蛋白酶-8(MMP-8)]、日常生活活动能力[改良Barthel指数（MBI）、功能独立性评定量表（FIM）]以及预后转归[格拉斯哥预后评定量表（GOS）]的差异。结果 研究组术后动脉瘤完全栓塞率为95.83%高于对照组的81.40%(P<0.05)；研究组术后颅内出血控制率为97.92%高于对照组的90.70%(P<0.05)；研究组术后并发症发生率为8.33%低于对照组的25.58%(P<0.05)；两组患者术后24 h炎症因子IL-6、TNF-α、MMP-8水平均低于同组术前，且研究组低于对照组（P<0.05）；研究组患者日常生活活动能力MBI、FIM评分高于对照组（P<0.05）。两组患者术后90 d预后转归GOS评分均高于术后30 d，且研究组术后30 d、90 d的GOS评分均高于对照组，研究组术后良好预后率为87.50%高于对照组的67.44%(P<0.05)。结论脑动脉瘤破裂出血患者接受血管介入栓塞术的治疗时机对其疗效及近远期预后具有显著影响，发病24 h内接受治疗的患者预后更佳。更多还原

【Abstract】 Objective To explore the effects of different timing of vascular interventional embolization on curative effect and short-term prognosis of patients with cerebral aneurysm rupture and hemorrhage. Methods The clinical data were collected from 91 patients with cerebral aneurysm rupture and hemorrhage in Dongtai People’s Hospital between April 2022 and April 2024. According to different timing of vascular interventional embolization, patients were divided into control group(24h after onset, n=43) and study group(within 24h after onset, n=48). The clinical curative effect, incidence of complications, inflammatory factors [interleukin-6(IL-6), tumor necrosis factor α(TNF-α), matrix metalloproteinase-8(MMP-8)], activities of daily living [Modified Barthel Index(MBI), Function Independent Measure(FIM)] and prognosis [Glasgow Outcome Scale(GOS)] were compared between the two groups. Results After surgery, complete embolization rate of aneurysms in study group was higher than that in control group(95.83% vs 81.40%, P<0.05), and control rate of intracranial hemorrhage was also higher than that in control group(97.92% vs 90.70%, P<0.05). The incidence of postoperative complications in study group was lower than that in control group(8.33% vs 25.58%, P<0.05). 24 h after surgery, levels of inflammatory factors(IL-6, TNF-α, MMP-8) were decreased in both groups, but lower in study group than control group(P<0.05). The scores of MBI and FIM in study group were higher than those in control group(P<0.05). GOS scores at 90 d after surgery were higher than those at 30 d after surgery in both groups, and GOS scores in study group were higher than those in control group at 30 d and 90 d after surgery. After surgery, good prognosis rate in study group was higher than that in control group(87.50% vs 67.44%, P<0.05). Conclusion The timing of vascular interventional embolization has significant influences on curative effect and short-term prognosis of patients with cerebral aneurysm rupture and hemorrhage, and prognosis is better in patients given treatment within 24 h after onset.更多还原