Efficacy of emergency surgery on controlling the condition and improving prognosis of patients with intracranial aneurysms

doi:10.3877/cma.j.issn.2095-9133.2018.02.006

Abstract

Abstract:

Objective

To investigate the effect of intravascular embolization intervention and microsurgery in the treatment of intracranial aneurysms and its role in improving the prognosis.

Methods

A total of 106 patients with intracranial aneurysms treated with neurosurgery from April 2015 to July 2017 who had volunteered to receive treatment at the People’s Hospital of West Coast New District of Qingdao were selected. Among them, 59 were males and 47 were females, aged 27 to 76 years. The mean age was(45.69±6.33)years and a prospective randomized controlled study was conducted. This study was approved by the Ethics Committee of the People’s Hospital of West Coast New District of Qingdao City. Patients and their families have the right to know about the surgical plan. According to the random number method, 106 patients were divided into control group and observation group, 53 cases in each group. The control group was treated with emergency endovascular embolization and the observation group was treated with emergency microsurgery. Enzyme-linked immunosorbent assay was used to compare the levels of TNF-α and IL-6 in venous blood before and after surgery in both groups; The number of vegetative and death cases was compared with the effect of different surgical methods on the prognosis of patients.

Results

Pre- and Postoperative TNF-αin both groups [Observation group: (36.94±4.27)ng/mL ratio(135.61±12.51)ng/mL; Control group: (38.12±4.31)ng/mL ratio(134.05±12.39)ng/ mL] and IL-6 [Observation group: (1.05±0.47)ng/mL ratio(7.93±1.35)ng/mL; Control group: (1.07±0.49)ng/mL ratio(7.95±1.36)ng/mL] were compared. The postoperative levels of TNF-αand IL-6were significantly lower than that before surgery, but there were no significant differences in TNF-α and IL-6 levels between the two groups. [TNF-α: (36.94±4.27)ng/mL ratio(38.12±4.31)ng/ mL, IL-6: (1.05±0.47)ng/mL ratio(1.07±0.49)ng/mL, P>0.05)]. The patients in the observation group had better cure and recovery rates after surgery than those in the control group (P<0.05). The observation group had lower rates of disability, vegetative events and mortality than the control group (P<0.05).

Conclusion

Both endovascular embolization and emergency microsurgery can control the condition of patients with intracranial aneurysms. However, emergency microsurgery can obtain better operative prognosis and lower mortality. It is worthy of popularization and application.

Key words: Endovascular embolization, Microsurgery, Intracranial aneurysm, Tumor necrosis factor-α, Pro-IL-6

Kun Wang, Bing Li, Guanglei Liu, Jianyong Chen, Peng Zhao, Yongshuai Fan, Shaohu Zhang, Jiameng Zang, Dongqi Wang. Efficacy of emergency surgery on controlling the condition and improving prognosis of patients with intracranial aneurysms[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2018, 04(02): 88-91.

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References 14

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组别	例数(例)	TNF－α(ng/mL)		t值	P值	IL－6(ng/mL)		t值	P值
组别	例数(例)	手术前	手术后	t值	P值	手术前	手术后	t值	P值
观察组	53	135.61±12.51	36.94±4.27^a	10.29	<0.05	7.93±1.35	1.05±0.47	7.38	<0.05
对照组	53	134.05±12.39	38.12±4.31^b	8.38	<0.05	7.95±1.36	1.07±0.49	8.99	<0.05
t值	?	1.90	2.42	?	?	0.90	1.69	?	?
P值	?	>0.05	>0.05	?	?	>0.05	>0.05	?	?

组别	例数(例)	TNF－α(ng/mL)		t值	P值	IL－6(ng/mL)		t值	P值
组别	例数(例)	手术前	手术后	t值	P值	手术前	手术后	t值	P值
观察组	53	135.61±12.51	36.94±4.27^a	10.29	<0.05	7.93±1.35	1.05±0.47	7.38	<0.05
对照组	53	134.05±12.39	38.12±4.31^b	8.38	<0.05	7.95±1.36	1.07±0.49	8.99	<0.05
t值	?	1.90	2.42	?	?	0.90	1.69	?	?
P值	?	>0.05	>0.05	?	?	>0.05	>0.05	?	?

组别	例数	治愈	恢复良好	残疾	植物生存	死亡
观察组	53	41(77.36)	7(13.21)	2(3.77)	1(1.89)	1(1.89)
对照组	53	31(58.49)	11(20.75)	4(7.55)	3(5.66)	4(7.55)
χ²值	?	5.20	6.89	4.58	7.18	5.75
P值	?	<0.05	<0.05	<0.05	<0.05	<0.05

组别	例数	治愈	恢复良好	残疾	植物生存	死亡
观察组	53	41(77.36)	7(13.21)	2(3.77)	1(1.89)	1(1.89)
对照组	53	31(58.49)	11(20.75)	4(7.55)	3(5.66)	4(7.55)
χ²值	?	5.20	6.89	4.58	7.18	5.75
P值	?	<0.05	<0.05	<0.05	<0.05	<0.05

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