中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2013年
3期
275-277
,共3页
血管介入%栓塞%动脉瘤%动眼神经麻痹%脑损伤%动眼神经功能
血管介入%栓塞%動脈瘤%動眼神經痳痺%腦損傷%動眼神經功能
혈관개입%전새%동맥류%동안신경마비%뇌손상%동안신경공능
Vascular intervention%Embolization%Aneurysm%Oculomotor nerve palsy%Brain Injury%Oculomotor nerve function
目的 探讨血管内介入栓塞治疗对后交通动脉瘤伴动眼神经麻痹患者脑损伤及神经功能的影响. 方法 郑州大学第一附属医院神经外科自2007年1月至2011年1月共收治后交通动脉瘤伴动眼神经麻痹患者84例,其中采用血管内介入栓塞治疗和显微外科手术治疗各42例,比较2组患者手术时间、术中出血量、术后恢复呼吸时间和拔除气管导管时间,手术结束时血清神经元特异性烯醇化酶(NSE)、葡萄糖和乳酸水平,出院时患者动眼神经的恢复和并发症的发生情况. 结果 血管内介入栓塞治疗组患者手术时间、术中出血量、术后拔除气管导管时间,手术结束时血清NSE、葡萄糖和乳酸水平,术后脑血管痉挛、脑水肿的发生率均低于显微外科手术治疗组,差异有统计学意义(P＜0.05).2组患者术后动眼神经完全恢复率的差异无统计学意义(P＜0.05). 结论 与显微外科手术比较,血管内介入栓塞治疗后交通动脉瘤伴动眼神经麻痹时出血和并发症少、恢复快,改善动眼神经麻痹的效果相当.
目的 探討血管內介入栓塞治療對後交通動脈瘤伴動眼神經痳痺患者腦損傷及神經功能的影響. 方法 鄭州大學第一附屬醫院神經外科自2007年1月至2011年1月共收治後交通動脈瘤伴動眼神經痳痺患者84例,其中採用血管內介入栓塞治療和顯微外科手術治療各42例,比較2組患者手術時間、術中齣血量、術後恢複呼吸時間和拔除氣管導管時間,手術結束時血清神經元特異性烯醇化酶(NSE)、葡萄糖和乳痠水平,齣院時患者動眼神經的恢複和併髮癥的髮生情況. 結果 血管內介入栓塞治療組患者手術時間、術中齣血量、術後拔除氣管導管時間,手術結束時血清NSE、葡萄糖和乳痠水平,術後腦血管痙攣、腦水腫的髮生率均低于顯微外科手術治療組,差異有統計學意義(P＜0.05).2組患者術後動眼神經完全恢複率的差異無統計學意義(P＜0.05). 結論 與顯微外科手術比較,血管內介入栓塞治療後交通動脈瘤伴動眼神經痳痺時齣血和併髮癥少、恢複快,改善動眼神經痳痺的效果相噹.
목적 탐토혈관내개입전새치료대후교통동맥류반동안신경마비환자뇌손상급신경공능적영향. 방법 정주대학제일부속의원신경외과자2007년1월지2011년1월공수치후교통동맥류반동안신경마비환자84례,기중채용혈관내개입전새치료화현미외과수술치료각42례,비교2조환자수술시간、술중출혈량、술후회복호흡시간화발제기관도관시간,수술결속시혈청신경원특이성희순화매(NSE)、포도당화유산수평,출원시환자동안신경적회복화병발증적발생정황. 결과 혈관내개입전새치료조환자수술시간、술중출혈량、술후발제기관도관시간,수술결속시혈청NSE、포도당화유산수평,술후뇌혈관경련、뇌수종적발생솔균저우현미외과수술치료조,차이유통계학의의(P＜0.05).2조환자술후동안신경완전회복솔적차이무통계학의의(P＜0.05). 결론 여현미외과수술비교,혈관내개입전새치료후교통동맥류반동안신경마비시출혈화병발증소、회복쾌,개선동안신경마비적효과상당.
Objective To explore the effects of endovascular embolization treatment on brain damage and recovery of neurological function in patients with posterior communicating artery aneurysm combined with oculomotor nerve palsy.Methods Eighty-four patients with posterior communicating artery aneurysm combined with oculomotor nerve palsy,admitted to our hospital from January 2007 to January 2011,were chosen in our study; 42 of them used intravascular interventional therapy (group A)and other 42 used microsurgical treatment (group B); the operation time,intraoperative blood loss,time of postoperative recovery respiratory and postoperative extubation time between the groups were compared; and the levels of serum neuron specific enolase (NSE),glucose and lactic acid at the end of the operation,postoperative recovery of the oculomotor nerve palsy and postoperative complications at discharge of the hospital were observed and compared between the two groups.Results As compared with group B,group A had significantly shorter operation time and postoperative extubation time (P＜0.05),and significantly less intraoperative bleeding (P＜0.05); NSE,glucose and lactic acid levels in group A were significantly lower than those in group B at the end of the operation (P＜0.05); the incidence of cerebral vasospasm and cerebral edema in group A were obviously lower than that in group B (P＜0.05).The complete recovery of oculomotor nerve paralysis showed no significant difference between the two groups (P＞0.05).Conclusion As compared with microsurgical treatment,intravascular interventional therapy has good effects (no bleeding,rapid recovery and few complications) in patients with posterior communicating artery aneurysms combined with oculomotor nerve palsy.
