作者：王黎明，袁璞，孙威，杜合宾

单位：

1.223800江苏省宿迁市，南京鼓楼医院集团宿迁医院 徐州医科大学附属宿迁医院神经内科 2.223800江苏省宿迁市，南京鼓楼医院集团宿迁医院 徐州医科大学附属宿迁医院神经外科 通信作者：袁璞，E-mail：yuanpu198182@163.com

单位（英文）：

1.Department of Neurology, Nanjing Drum Tower Hospital Group Suqian Hospital/the Affiliated Suqian Hospital of Xuzhou Medical University, Suqian 223800, China 2.Department of Neurosurgery, Nanjing Drum Tower Hospital Group Suqian Hospital/the Affiliated Suqian Hospital of Xuzhou Medical University, Suqian 223800, China Corresponding author: YUAN Pu, E-mail: yuanpu198182@163.com

关键词：

颅内动脉瘤; 动脉瘤,破裂; 栓塞疗法; 支架置入; 治疗结果;

关键词（英文）：

Intracranial aneurysm; Aneurysm, ruptured;Embolotherapies; Stent placement; Treatment outcome

中图分类号：

DOI：

10.12114/j.issn.1008-5971.2023.00.002

基金项目：

江苏省卫生健康委医学科研项目（H201991）；宿迁市科技计划项目（Z2020100）

摘要：

目的 分析栓塞联合支架置入治疗急性期破裂颅内动脉瘤的效果。方法 选取2017年1月至2020年1月南京鼓楼医院集团宿迁医院收治的急性期破裂颅内动脉瘤患者94例为研究对象，采用随机数字表法将其分为观察组与对照组，各47例。对照组接受单纯栓塞治疗，观察组接受栓塞联合支架置入治疗。比较两组栓塞效果，手术前后动脉瘤影像学特征[包括尺寸比（SR）、纵横比（AR）、入射角]及血清神经元特异性烯醇化酶（NSE）、S100B蛋白水平，并发症发生率，术后12个月格拉斯哥预后量表（GOS）评分、复发率。结果 观察组栓塞效果优于对照组（P<0.05）。对照组、观察组术后SR、AR、入射角分别小于本组术前，且观察组小于对照组（P<0.05）。两组术后NSE、S100B蛋白水平比较，差异无统计学意义（P>0.05）；对照组、观察组术后NSE、S100B蛋白水平分别高于本组术前（P<0.05）。两组并发症总发生率比较，差异无统计学意义（P>0.05）。观察组GOS评分高于对照组，复发率低于对照组（P<0.05）。结论 栓塞联合支架置入可有效提高急性期破裂颅内动脉瘤患者的栓塞效果，安全性较好，且可改善患者短期预后，降低患者短期复发率。

英文摘要：

【Abstract】 Objective To observe the effect of embolization combined with stent implantation in the treatment of acute ruptured intracranial aneurysm. Methods A total of 94 patients with acute ruptured intracranial aneurysm admitted to Nanjing Drum Tower Hospital Group Suqian Hospital from January 2017 to January 2020 were selected as the research objects, and were divided into observation group and control group by random number table method, with 47 cases in each group. The control group received simple embolization, and the observation group received embolization combined with stent implantation. The effect of embolization, the imaging characteristics of aneurysms [including size ratio (SR) , aspect ratio (AR) , angle of incidence] and serum neuron specific enolase (NSE) and S100B protein levels before and after operation, complication rate, Glasgow Outcome Scale (GOS) score and recurrence rate at 12 months after operation were compared between the two groups. Results The embolic effect of the observation group was better than that of the control group (P < 0.05) . The SR, AR and incidence angle after operation of the control group and the observation group were smaller than those before operation respectively, and the SR, AR and incidence angle after operation of the observation group were smaller than those of the control group (P < 0.05) . There was no significant difference in the serum levels of NSE and S100B protein between the two groups (P > 0.05) ; the serum levels of NSE and S100B protein in the control group and the observation group after operation were higher than those before operation, respectively (P < 0.05) . There was no significant difference in the total incidence of complications between the two groups (P > 0.05) . GOS score in the observation group was higher than that in the control group, and the recurrence rate was lower than that in the control group (P < 0.05) . Conclusion Embolization combined with stent implantation can effectively improve the embolization effect of patients with acute ruptured intracranial aneurysm, with good safety, and can improve the short-term prognosis of patients, reduce the short-term recurrence rates of patients.

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