不同前交通动脉瘤直回切除范围在前交通动脉瘤患者中的应用效果

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摘要目的探讨不同前交通动脉瘤直回切除范围在前交通动脉瘤患者中的应用效果。方法选取2017年1月～2018年1月我院收治的52 例前交通动脉瘤患者作为研究对象，按照不同切除范围将其分为对照组（22 例）与研究组（30 例）。对照组患者采用标准直回切除（切除范围≤1 cm3）方法，研究组患者采用大范围直回切除（切除范围＞1 cm3）方法，同时选取同期30 例体检结果正常者为健康组。比较对照组与研究组出现认知障碍的概率，比较三组的简易智力状态检查量表（MMSE）及记忆力[简化雷-奥复杂图形测试（ROCFT）、世界卫生组织-加州大学洛杉矶分校听觉词语学习测验（WHO-UCLAAVLT）]评分。结果研究组出现认知功能障碍的概率高于对照组，差异有统计学意义（P＜0.05）。研究组的回忆能力、记忆力、语言能力、计算能力及注意力、定向力及MMSE 总分均低于对照组和健康组，对照组的回忆能力、记忆力、语言能力、计算能力及注意力、定向力及MMSE 总分均低于健康组，差异有统计学意义（P＜0.05）。研究组的词语再认、即刻记忆及长时间延迟记忆简化ROCFT 评分均低于对照组和健康组，对照组的词语再认、即刻记忆及长时间延迟记忆简化ROCFT 评分均低于健康组，差异有统计学意义（P＜0.05）；研究组的短时间延迟记忆、长时间延迟记忆及即刻记忆WHO-UCLAAVLT 评分均低于对照组和健康组，对照组的短时间延迟记忆、长时间延迟记忆及即刻记忆WHO-UCLAAVLT 评分均低于健康组，差异有统计学意义（P＜0.05）。结论前交通动脉瘤直回切除范围较小，对患者术后认知障碍影响不明显；前交通动脉瘤直回切除范围较大，对患者术后认知障碍影响较大。不同前交通动脉瘤直回切除范围对术后认知障碍有一定影响。

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	张海阳

关键词 ：前交通动脉瘤, 直回切除范围, 术后认知障碍, 简易智力状态检查量表, 语言能力, 记忆力评分

Abstract：Objective To investigate the application effect of different anterior communicating aneurysms direct resection scope in patients with anterior communicating aneurysms. Methods A total of 52 patients with anterior communicating aneurysms admitted to our hospital from January 2017 to January 2018 were enrolled. The patients were divided into control group (22 cases) and study group (30 cases) according to different resection areas. The patients in the control group were treated with standard direct resection (resection range ≤1 cm3),and the patients in the study group were treated with a large range of direct resection (resection range ＞1 cm3). At the same time, 30 healthy people with normal physical examination results were selected as the healthy group. The probability of cognitive dysfunction between the control group and the study group was compared, and scores of mini-mental state examination (MMSE) and memory(simplified Rey-Osterreith complex figure test [ROCFT], World Health Organization-University of California Los Angeles auditory vocabulary learning test [WHO-UCLAAVLT]) were compared among the three groups. Results The probability of cognitive dysfunction in the study group was higher than that in the control group, and the difference was statistically significant (P＜0.05). The recall ability, memory ability, language ability, computing ability and attention, orientation and total scores of MMSE in the study group were lower than those in the control group and in the healthy group, the recall ability, memory ability, language ability, computing ability and attention, orientation and total scores of MMSE in the control group were lower than those in the healthy group, and the differences were statistically significant(P＜0.05). The simplified ROCFT scores such as word recognition, immediate memory and long-term delayed memory of the study group were lower than those of the control group and the healthy group, the simplified ROCFT scores of the control group such as word recognition, immediate memory and long-delayed memory were lower than those of the healthy group, with statistically significant differences (P＜0.05). The WHO-UCLAAVLT scores such as short-term delayed memory, long-term delayed memory and immediate memory of the study group were lower than those of the control group and the healthy group, the WHO-UCLAAVLT scores such as short-term delayed memory, long-term delayed memory and immediate memory of the control group were lower than those of the healthy group, and the differences were statistically significant (P＜0.05). Conclusion The influence of cognitive impairment is not obvious when the direct resection of the anterior communicating aneurysm scope is smaller. A larger scope direct anterior communicating aneurysm has a greater impact on the postoperative cognitive impairment. The scope of direct aneurysm resection has a certain impact on postoperative cognitive impairment.

Key words： Anterior communicating aneurysm Scope of direct resection Postoperative cognitive impairment Minimental state examination Language ability Memory score

引用本文:

张海阳. 不同前交通动脉瘤直回切除范围在前交通动脉瘤患者中的应用效果[J]. 中国当代医药, 2020, 27(16): 67-70转74.
ZHANG Hai-yang. Application effect of different anterior communicating aneurysms direct resection scope in patients with anterior communicating aneurysms. 中国当代医药, 2020, 27(16): 67-70转74.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2020/V27/I16/67

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