关键词: 颅内动脉瘤, 破裂, 神经介入栓塞, 疗效, 神经功能

Abstract: Objective  To investigate the effect of early nerve interventional embolization after ruptured intracranial aneurysm (IA) and its effect on nerve function.Methods  A total of 100 patients with ruptured IA who underwent neurointerventional embolization in our hospital from January 2020 to January 2023 were selected and divided into two groups according to the timing of surgery.The control group (n=49) underwent surgery 24-72 hours after rupture of IA,while the study group (n=51) underwent surgery within 24 hours after rupture of IA.The success rate of embolization,serum inflammatory stress factor [interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α),D-dimer (D-D),malondialdehyde (MDA)],cerebrovascular spasticity (CVS) related factors [hypoxia-inducing factor 1α (HIF-1α)],soluble intercellular adhesion molecule-1 (SICAM-1),cysteine aspartate proteolytic enzyme 3 (Caspase-3),neurological function (NIHSS score),capacity of daily living (BI score),complications (cerebral vasospasm) and short-term prognosis were compared between the two groups.Results  The success rate of embolization in the study group was 94.12%,which was higher than that in the control group (79.59%) (P<0.05).The serum IL-6 levels in the study group on day 1,3,and 7 after surgery were (18.06±5.11) ng/L,(17.15±4.60) ng/L,and (16.37±4.35) ng/L,respectively,while those in the control group were (23.18±5.92) ng/L,(21.23±5.54) ng/L,and (20.16±5.29) ng/L,respectively,the TNF-α levels were (32.01±7.19) ng/ml,(30.67±6.85) ng/ml,and (29.45±6.63) ng/ml,respectively,while those in the control group were (39.01±8.20) ng/ml,(36.22±7.53) ng/ml,and (35.01±7.12) ng/ml,respectively,the D-D levels were (27.19±4.89) μg/ml,(26.20±4.71) μg/ml,and (25.81±4.39) μg/ml,respectively,while those in the control group were (32.06±5.94) μg/ml,(31.18±5.49) μg/ml,and (30.26±5.61) μg/ml,respectively,the MDA levels were (2.81±0.83) μmol/ml,(2.53±0.75) μmol/ml,and (2.46±0.71) μmol/ml,respectively,while those in the control group were (4.02±1.01) μmol/ml,(3.84±0.91) μmol/ml,and (3.59±0.86) μmol/ml,respectively,and the differences between the two groups were statistically significant (P<0.05);on postoperative day 1,3,and 7,the serum HIF-1α levels in the study group were (95.16 ± 8.21) pg/ml,(93.25±7.94) pg/ml,and (92.54±7.80) pg/ml,respectively,while those in the control group were (102.31±8.56) pg/ml,(100.27±8.19) pg/ml,and (99.65±7.92) pg/ml,respectively,the SICAM-1 levels were (620.15±78.92) ng/ml,(616.37±75.28) ng/ml,and (610.92±73.69) ng/ml,respectively,while those in the control group were (683.19±80.24) ng/ml,(680.24±78.51) ng/ml,and (675.31±75.92) ng/ml,respectively,the caspase-3 levels were (645.13±88.61) mg/ml,(640.21±85.76) mg/ml,and (633.79±82.65) mg/ml,respectively,while those in the control group were (720.13±90.54) mg/ml,(717.03±88.65) mg/ml,and (712.81±85.04) mg/ml,respectively,and there were significant differences between the two groups (P<0.05);the NIHSS scores of the study group at 1 month and 3 months after surgery were (5.20±1.37) scores and (5.03±1.32) scores,respectively,while those of the control group were (6.31±1.50) scores and (6.17±1.45) scores,respectively,the BI scores were (78.01±5.73) scores and (79.12±5.81) scores,respectively,while those of the control group were (72.69±5.50) scores and (73.24±5.72) scores,respectively,and the difference between the two groups was statistically significant (P<0.05).The incidence of complications in the study group was 7.84%,which was lower than that of the control group (22.45%) (P<0.05).The good prognosis rate in the study group was 82.35%,which was higher than that of the control group (61.22%) (P<0.05).Conclusion   Neurological intervention and embolization within 24 hours after rupture of IA has significant therapeutic effects and can more effectively improve patients’ neurological function and prognosis.

Key words: intracranial aneurysm, ruptured, nerve interventional embolization, curative effect, neural function