引用本文:程守雨,王言董,张继全.微创手术治疗中量高血压脑出血的临床疗效观察[J].中国临床新医学,2020,13(2):183-186.
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微创手术治疗中量高血压脑出血的临床疗效观察
程守雨,王言董,张继全
276600 山东,莒南县人民医院神经外科
摘要:
[摘要] 目的 观察微创手术治疗中量高血压脑出血的疗效及对患者血清炎性因子的影响。方法 选取该院2016-01~2018-01收治的56例中量高血压脑出血患者,按手术方法分为观察组和对照组,各28例。观察组行微创穿刺引流术治疗,对照组行小骨窗开颅术治疗,比较两组临床疗效。结果 观察组住院时间短于对照组(P<0.05),住院费用低于对照组(P<0.05),两组血肿清除率比较差异无统计学意义(P>0.05)。术后7 d,两组炎性因子TNF-α、IL-6、hs-CRP水平均降低,且观察组明显低于对照组(P<0.05)。术后6个月,两组中国卒中量表(CSS)、日常生活活动能力(ADL)评分均较术前明显降低,且观察组低于对照组(P<0.05)。观察组并发症发生率明显低于对照组(10.71% vs 35.71%,P<0.05)。结论 微创手术治疗中量高血压脑出血具有良好的血肿清除效果,利于减轻炎性反应,改善患者神经功能缺损程度及日常生活能力,且并发症少,安全可靠。
关键词:  高血压  脑出血  微创手术  炎性反应
DOI:10.3969/j.issn.1674-3806.2020.02.20
分类号:R 651.1+2
基金项目:
Observation on the clinical effect of minimally invasive surgery on moderate amount of hypertensive intracerebral hemorrhage
CHENG Shou-yu, WANG Yan-dong, ZHANG Ji-quan
Department of Neurosurgery, the People′s Hospital of Junan County, Shandong 276600,China
Abstract:
[Abstract] Objective To observe the curative effect of minimally invasive surgery on moderate amount of hypertensive intracerebral hemorrhage and its effect on serum inflammatory factors. Methods A total of 56 patients with moderate amount of hypertensive intracerebral hemorrhage who were admitted to our hospital from January 2016 to January 2018 were enrolled in this study, and were divided into control group and observation group according to the different operation methods, with 28 cases in each group. The observation group underwent minimally invasive puncture and drainage, and the control group underwent small bone window craniotomy. The clinical efficacy was compared between the two groups. Results The hospital stay in the observation group was significantly shorter than that in the control group(P<0.05), and the hospitalization costs in the observation group were significantly lower than those in the control group(P<0.05). There was no significant difference in hematoma clearance rate between the two groups(P>0.05). The levels of inflammatory factors[tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) and high-sensitivity C-reactive protein(hs-CRP)] were decreased in the two groups 7 days after operation, and the inflammatory factors in the observation group were significantly lower than those in the control group(P<0.05). The scores of Chinese Stroke Scale(CSS) and Activity of Daily Living(ADL) Scale in the two groups 6 months after operation were significantly lower than those before operation, and the scores in the observation group were significantly lower than that in the control group(P<0.05). The incidence of complications in the observation group was significantly lower than that in the control group(10.71% vs 35.71%, P<0.05). Conclusion Minimally invasive surgery has a good effect of clearing hematoma on moderate amount of hypertensive intracerebral hemorrhage, which can reduce the inflammatory response, improve the degree of neurological deficits and daily living ability. The operation is safe and reliable and has few complications.
Key words:  Hypertension  Cerebral hemorrhage  Minimally invasive surgery  Inflammatory response