中国医药指南

目的 探究动脉瘤性蛛网膜下腔出血（aSAH）经血管介入栓塞术治疗的效果。方法 采用随机数字表法将前瞻性选取的南充市高坪区人民医院的aSAH患者80例，分为观察组和对照组，两组患者均在2020年1月至2024年12月于本院治疗，每组40例。观察组行血管介入栓塞术，对照组行颅内动脉瘤夹闭术。记录两组手术时长、术中出血量，比较两组术前、术后3 d血清免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、高迁移率组蛋白B1(HMGB1)、可溶性细胞间黏附因子-1(sICAM-1)、可溶性血管细胞黏附因子-1(s VCAM-1)，统计两组术后7 d并发症发生率和术后8周预后情况。结果 观察组手术时长、术中出血量均低于对照组（P<0.05）。术后3 d，两组IgG、IgM、IgA、HMGB1、sICAM-1、sVCAM-1水平较术前降低（P<0.05）；但观察组IgG、IgM、IgA相比对照组较高，HMGB1、sICAM-1、sVCAM-1相比对照组较低（P<0.05）。观察组术后7 d并发生发生率较对照组低（P<0.05）。观察组术后8周格拉斯哥预后量表（GOS）评分优于对照组（P<0.05）。结论 aSAH患者经血管介入栓塞术治疗对免疫功能的抑制程度更轻，在降低炎症反应、减少并发症的发生和改善短期预后方面具有明显的优势。

Objective To explore the effects vascular interventional embolization treatment with aneurysmal subarachnoid hemorrhage(aSAH).Methods Eighty patients with aSAH from Gaoping District People's Hospital were prospectively selected and divided into an observation group and a control group using a random number table method.Both groups were treated from January 2020 to December 2024,with 40 patients in each group.The observation group underwent vascular intervention embolization,while the control group underwent intracranial aneurysm clipping surgery.Record the duration of two sets of surgeries and the amount of intraoperative bleeding.The serum levels of immunoglobulin G(IgG),immunoglobulin M(IgM),immunoglobulin A(IgA),high mobility group protein B1(HMGB1),soluble intercellular adhesion molecular-1(sICAM-1),and soluble vascular cell adhesion factor-1(sVCAM-1) between two groups before and3 days after surgery,and calculate the incidence of complications at 7 days after surgery and the prognosis at 8 weeks after surgery were compared.Results The observation group had lower surgical duration and intraoperative bleeding compared to the control group(P<0.05).Compared with pre-operation,3 days after surgery,IgG,IgM,IgA,HMGB1,sICAM-1,and sVCAM-1 levels decreased(P<0.05).However,after surgery,the observation group had higher levels of IgG,IgM,and IgA compared to the control group,while HMGB1,sICAM-1,and sVCAM-1 were lower compared to the control group(P<0.05).Compared with the control group,there were significant reductions in the incidence of postoperative complications in the observation group 7 days after surgery(P<0.05).The Glasgow outcome scale(GOS) score was better in the observation group than that of the control group 8 weeks after surgery(P<0.05).Conclusions The degree of immune suppression in aSAH patients treated with vascular interventional embolization is lighter,which has significant advantages in reducing inflammatory reactions,minimizing the occurrence of complications,and improving short-term prognosis.