| 汤加家,刘希光,伦志刚,等.颈内动脉交通段破裂动脉瘤的外科显微夹闭治疗的临床研究[J].安徽医药,2022,26(4):782-787. |
| 颈内动脉交通段破裂动脉瘤的外科显微夹闭治疗的临床研究 |
| Clinical study of surgical microclamping of ruptured aneurysms in the communicating segment of the internal carotid artery |
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| DOI：10.3969/j.issn.1009-6469.2022.04.032 |
| 中文关键词: 颈内动脉夹层 颅内动脉瘤 外科器械 蛛网膜下腔出血 中性粒细胞 /淋巴细胞比值( NLR) CT血管造影(CTA) 数字减影脑血管造影(DSA) 显微夹闭 预后 |
| 英文关键词: Internal,carotid artery,dissection Intracranial aneurysm Surgical instruments Subarachnoid hemorrhage Neu-trophil-to-lymphocyte ratio (NLR) CT angiography (CTA) Digital subtraction angiography (DSA) Microclamping Prognosis |
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| 中文摘要: |
| 目的探讨颈内动脉交通段破裂动脉瘤外科显微夹闭治疗的安全性、有效性。方法选取徐州医科大学附属连云港医院 2016年 1月至 2019年 9月收住入院的 212例颈内动脉交通段破裂动脉瘤病人，其中 49例未行手术治疗，余 163例均行外科显微夹闭治疗。结果本研究纳入病人 163例，其中预后良好病人 122例，预后不良病人 41例。单因素分析结果表明手术时机［预后良好组超早期 37例( 30.3%)，次早期 50例( 41%)，间期 32例( 26.2%)，晚期 3例( 2.5%)；预后不良组超早期 6例 |
| 英文摘要: |
| Objective To investigate the safety and efficacy of surgical microclamping of ruptured aneurysms in the communicatingsegment of the internal carotid artery.Methods A total of 212 patients with ruptured aneurysms in the internal carotid artery commu nicating segment admitted to Xuzhou Medical University Affiliated Lianyungang Hospital from January 2016 to September 2019 wereselected. Among them, 49 patients did not undergo surgical treatment, and the remaining 163 patients underwent surgical microclamp ing treatment.Results This study included 163 patients, including 122 patients with good prognosis and 41 patients with poor progno sis. Univariate analysis showed that the timing of surgery [good prognosis group: 37 cases (30.3%) in the super early stage, 50 cases(41%) in the second early stage, 32 cases (26.2%) in the interval, and 3 cases (2.5%) in the late stage; the poor prognosis group: 6 cases(14.6%) in super early stage, 7 cases (17.1%) in second early stage, 27 cases (65.9%) in interval, 1 case (2.4%) in the late stage; Hunt-Hess classification [good prognosis group: 109 cases (89.3%) in the low grade, 13 cases (10.7%) in high grade group; poor prognosisgroup: 11 cases (26.8%) in the low grade and 30 cases (73.2%) in high grade group]; intraoperation aneurysm ruptured [good prognosisgroup: 113 cases (92.7%) were not ruptured during operation, 9 cases (7.3%) were ruptured during operation; poor prognosis group: 29cases (70.7%) were not ruptured during operation, 12 cases (29.2%) were ruptured during operation] showed significant differences be tween the two groups (P < 0.05); The results of multivariate analysis showed that the interval surgery, Hunt-Hess high-grade group, utro phil-to-lymphocyte ratio (NLR), and intraoperative aneurysm rupture were independent risk factors for patients with poor prognosis.Conclusion The incidence of poor prognosis in patients with ruptured C7 segment aneurysms is closely related to interval surgery,high Hunt-Hess grade, high NLR ratio, and intraoperative aneurysm rerupture. |
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