显微外科手术在颅内动脉瘤中的应用效果及对患者应激程度的影响研究

周伟　傅玉琼　范秀云　张明伟

【摘要】 目的：研究显微外科手术在颅内动脉瘤中的应用效果及对患者应激程度的影响。方法：选取2017年4月-2018年1月笔者所在医院收治的82例颅内动脉瘤患者为研究对象，将其随机分为两组，每组41例。对照组进行血管内介入治疗，观察组则进行显微外科夹闭手术治疗。比较两组患者术后不同时间的GOS评分、手术前后的血清应激激素。结果：观察组术后1周及4周GOS评分优于对照组（P<0.05），由术前至术后1、3 d两组内血清应激激素均先升后降，但两组见差异无统计学意义（P>0.05）。结论：显微外科手术在颅内动脉瘤中的应用效果较好，且对患者的不良应激尚可，故在颅内动脉瘤患者中的应用价值较高。

【关键词】 显微外科手术; 颅内动脉瘤; 应用效果; 应激程度

doi：10.14033/j.cnki.cfmr.2019.03.014 文献标识码 B 文章编号 1674-6805（2019）03-00-02

Study on the Application Effect of Microscopic Surgery in the Patients with Intracranial Aneurysm and Influence for the Stress Degree/ZHOU Wei，FU Yuqiong，FAN Xiuyun，et al.//Chinese and Foreign Medical Research，2019，17（3）：-35

【Abstract】 Objective：To study the application effect of microscopic surgery in the patients with intracranial aneurysm and influence for the stress degree.Method：A total of 82 patients with intracranial aneurysm in hospital from April 2017 to January 2018 were chosen as the research object，and they were randomly into two groups，with 41 cases in each group.The control group were treated with endovascular interventional treatment，the observation group were treated with microsurgical clipping.Then the GOS score at different time after the operation，serum stress hormones before and after the operation of two groups were compared.Result：The GOS score of observation group at first and forth week after the operation were better than those of control group（P<0.05），the serum stress hormones of two groups before the operation and at first and third day after the operation increased first and decreased afterward，while the differences of two groups were not statistically significant（P>0.05）.Conclusion：The application effect of microscopic surgery in the patients with intracranial aneurysm is better，and its bad influence for the patients is still available，so its application value in the patients with intracranial aneurysm is higher.

【Key words】 Microscopic surgery; Intracranial aneurysm; Application effect; Stress degree

First-authors address：Hospital of Traditional Chinese Medicine Affiliated to Southwest Medical University，Luzhou 646000，China

顱内动脉瘤是发生于颅内动脉的一类病变，也是导致蛛网膜下腔出血的重要原因，且发病的年龄广泛，临床危害明显，因此临床对于本病的重视程度较高，相关的治疗研究多见。临床中近年来关于显微外科手术与血管内介入治疗的研究多见，但两类治疗方式的效果比较研究争议较大[1-2]，尤其是对于临床效果及机体应激反应方面的研究差异较大。因此本研究就显微外科手术在颅内动脉瘤中的应用效果及对患者应激程度的影响进行研究，并与血管内介入治疗的患者进行比较，结果总结如下。

1 资料与方法

1.1 一般资料

选取2017年4月-2018年1月笔者所在医院收治的82例颅内动脉瘤患者为研究对象，将其随机分为两组，每组41例。纳入标准：年龄20～75岁;符合颅内动脉瘤手术指征者;对研究知情同意者。排除标准：合并其他心肺肝肾等疾病者;合并内分泌性疾病者;合并其他脑部感染或疾病者;精神病史者。对照组中包括男21例，女20例，年龄22～73岁，平均（56.9±5.6）岁，其中前循环18例，后循环23例;Hunt-Hess分级：Ⅰ级者20例，Ⅱ级者16例，Ⅲ级者5例。观察组中包括男22例，女19例，年龄23～74岁，平均（57.1±5.8）岁，其中前循环17例，后循环24例;Hunt-Hess分级：Ⅰ级者20例，Ⅱ级者15例，Ⅲ级者6例。两组性别、年龄、部位及Hunt-Hess分级等方面比较，差异无统计学意义（P>0.05），具有可比性。本研究经医院伦理委员会批准。