早期介入治疗对颅内动脉瘤破裂患者预后的影响

摘要

目的：探讨早期介入治疗（Early Invasive Strategy ，EIS）对颅内动脉瘤破裂（Ruptured Intracranial Aneurysm ， RIA ）患者预后的影响。方法选择2011-09-2013-10接诊的RIA患者92例，按照发病时间到治疗时间的不同分为EIS组和晚期介入治疗（LIS）组，每组各46例。EIS组在发病后72 h内接受治疗，而LIS组在发病超过72h后接受治疗。比较2组术后栓塞情况、GOS预后评分和并发症发生情况。结果 EIS组完全栓塞38例（82.6％），大部分栓塞7例，部分栓塞1例， LIS组完全栓塞25例（54.3％），大部分栓塞12例，部分栓塞9例，EIS组栓塞效果明显优于LIS组；EIS组GOS≥4的患者39例（84.8％），LIS组GOS≥4的患者28例（60.9％），EIS组预后明显优于LIS组；EIS组并发症15例（32.6％），LIS组并发症3例（6.5％）；2组差异比较有统计学意义（ P＜0.05）。结论 EIS对RIA的治疗效果显著，能显著减少并发症的发生，保障患者安全，明显提升预后，值得临床推广。%Objective To explore the impact of early invasive strategy (EIS)on the prognosis of patients with ruptured in-tracranial aneurysms(RIA).Methods 92 patients with RIA in our hospital from September 2011 to October 2013 were chosen , and divided into two groups ,EIS group and late invasive strategy group (LIS) ,according to the different time of onset to the treatment time ,46 cases in each group. EIS group received treatment within 72 h after the onset ,and LIS group accepted treat-ment after 72 h of the onset. The status of embolization ,GOS prognostic score and complications of the two groups were ob-served and compared. Results 38 cases(82.6% ) were completely embolized ,7 cases were majorly embolized ,and 1 case was partially embolized in EIS group ;25 cases (54.3% ) were completely embolized ,12 cases were majorly embolized ,and 9 cases were partially embolized in LIS group ,embolization efficacy of EIS group was significantly better than that of LIS group ;39 ca-ses had GOS ≥ 4 in EIS group ,accounting for 84.8% ;and 28 cases had GOS ≥ 4 in LIS group ,accounting for 60.9%. The prognosis of EIS group was significantly better than that of the LIS group ;15 cases with complications in EIS group ,accounted for 32.6% ,and 3 patients with complications in LIS group ,accounted for 6.5% ;differences between the above items were sta-tistically significant (P<0.05).Conclusion EIS has a significant effect on the therapy for RIA ,and can significantly reduce the incidence of complications ,ensure the safety of patients ,as well as significantly improve the prognosis ,and thus is worthy of further promotion in clinical practice.