微创血肿穿刺术治疗高血压脑出血的疗效及其对炎性因子表达水平的影响

发布时间：2018-08-03 08:05

【摘要】：目的:通过对高血压脑出血患者采用微创血肿穿刺术治疗,评估其疗效及对炎性因子表达水平的影响。方法:对本院74例高血压脑出血患者依据建档顺序分2组,各37例。对照组采用小骨窗血肿清除术,研究组采用微创血肿穿刺术,术后3~6个月进行随访。对比两组手术情况、临床疗效、并发症发生率,评估术前及末次随访时两组神经功能缺损评分(NIHSS)、日常生活能力评分(BI)及检测其血清炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、高敏C反应蛋白(hs-CRP)]水平变化。结果:(1)手术情况:研究组手术用时(12.34±5.54)min,术中失血量(40.31±10.27)m L,下床活动时间(5.04±2.82)d,住院时间(16.30±2.61)d,均少于对照组,差异有统计学意义(P0.05);(2)神经功能及日常生活能力:术前两组NIHSS评分及BI评分比较,差异无统计学意义(P0.05),术后研究组NIHSS评分[(4.08±1.35)分]低于对照组[(6.49±1.13)分],BI评分[(60.63±8.08)分]高于对照组[(46.82±6.81)分],差异有统计学意义(P0.05);(3)临床疗效:研究组治疗有效率91.89%(34/37)高于对照组72.97%(27/37),差异有统计学意义(P0.05);(4)血清炎性因子:术前两组hs-CRP、IL-6、TNF-α水平比较,差异无统计学意义(P0.05),术后1周2组血清炎性因子水平均较术前降低,且研究组hs-CRP(7.14±3.05)mg/L、IL-6(14.18±3.16)ng/L、TNF-α(40.10±3.03)μg/L,低于对照组[(12.11±3.35)mg/L、IL-6(27.19±3.98)ng/L、TNF-α(53.22±3.32)μg/L],差异有统计学意义(P0.05);(5)并发症发生率:研究组并发症发生率5.41%(2/37)低于对照组24.32%(9/37),差异有统计学意义(P0.05)。结论:采用微创血肿穿刺术治疗高血压脑出血效果显著,可有效改善患者神经功能及日常生活能力,减少手术用时及术中失血量,降低血清炎性因子水平,提高治疗效果,且安全性较高。
[Abstract]:Objective: to evaluate the effect of minimally invasive hematocentesis on the expression of inflammatory factors in patients with hypertensive intracerebral hemorrhage. Methods: 74 patients with hypertensive intracerebral hemorrhage were divided into 2 groups, 37 cases each. The control group was treated with small bone window hematoma removal, the study group was treated with minimally invasive hematoma puncture and followed up 3 ~ 6 months after operation. Compared with the two groups, the operation, clinical efficacy, incidence of complications, The changes of serum inflammatory factors (TNF- 伪, interleukin-6 (IL-6), Gao Min C-reactive protein (hs-CRP) were evaluated before and at the last follow-up. The changes of (NIHSS), ADL score and serum inflammatory factors (TNF- 伪, IL-6, hs-CRP) in the two groups were evaluated. Results: (1) the operation time of the study group was (12.34 卤5.54) minutes, the amount of blood loss during operation was (40.31 卤10.27) m L, the time of getting out of bed was (5.04 卤2.82) days, the time of hospitalization was (16.30 卤2.61) days, the difference was statistically significant (P0.05); (2) the neurological function and daily life ability: the NIHSS score and BI score were compared between the two groups before operation. The NIHSS score of the study group [(4.08 卤1.35)] was lower than that of the control group [(6.49 卤1.13)] and the BI score of the control group [(60.63 卤8.08)] was higher than that of the control group [(46.82 卤6.81)], the difference was statistically significant (P0.05). The clinical efficacy of the study group was 91.89% (34 / 37) higher than that of the control group 72.97% (27 / 37). The difference was statistically significant (P0.05); (4). The levels of hs-CRP IL-6 TNF- 伪 were compared between the two groups before operation. There was no significant difference between the two groups (P0.05). The levels of serum inflammatory factors in the two groups were lower than those before operation at 1 week after operation. The hs-CRP of the study group was (7.14 卤3.05) mg / L IL-6 (14.18 卤3.16) ng / L (40.10 卤3.03) 渭 g / L, lower than that of the control group [(12.11 卤3.35) mg / L IL-6 (27.19 卤3.98) ng / L TNF- 伪 (53.22 卤3.32) 渭 g / L], and the incidence of complications in the study group was 5.41% (2 / 37) lower than that in the control group (24.32%) (P 0.05). Conclusion: minimally invasive hematocentesis is effective in the treatment of hypertensive intracerebral hemorrhage. It can effectively improve the nerve function and daily living ability of patients, reduce the amount of blood loss, reduce the level of serum inflammatory factors, and improve the therapeutic effect. And the safety is high.
【作者单位】：南京医科大学附属淮安第一医院神经外科;淮安市第二人民医院神经外科;
【基金】：淮安市科技支撑计划(HAS201518)
【分类号】：R651.12

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