研究早期微创颅内血肿清除术治疗高血压脑出血的效果
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摘要
目的研究早期微创颅内血肿清除术治疗高血压脑出血的临床疗效。方法选取2016年5月—2018年4月医院收治的高血压脑出血患者88例,在双盲法下均分为两组,包括对照组和观察组,每组各44例,对照组采用小骨窗血肿清除术,观察组采用早期微创血肿清除术,比较两组临床疗效。结果观察组治疗后的总有效率为93.18%,高于对照组的总有效率77.27%,差异有统计学意义(P <0.05);两组术后7 d、14 d时的白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)指标水平较术前均有明显变化,但观察组比对照组明显更低(P <0.05);两组术后14 d的神经功能缺损(NIHSS)评分均较术前显著降低,但观察组比对照组改善更明显(P <0.05)。结论临床治疗高血压脑出血采用早期微创颅内血肿清除术能够有效提高临床效果,促进炎症因子水平减轻,显著改善神经功能。
Objective To study the clinical effect of early minimally invasive intracranial hematoma removal in the treatment of hypertensive cerebral hemorrhage. Methods 88 patients with hypertensive intracerebral hemorrhage admitted to the hospital from May 2016 to April 2018 were divided into two groups by double blind method, including control group and observation group, 44 cases in each group. The control group was treated with small bone window hematoma removal, while the observation group was treated with early minimally invasive hematoma removal. The clinical efficacy of the two groups was compared. Results The total effective rate of the observation group after treatment was 93.18%, higher than that of the control group of 77.27%(P < 0.05). The levels of interleukin-6(IL-6) and tumor necrosis factor-alpha(TNF-alpha) at 7 and 14 days after operation in the two groups were significantly changed compared with those before operation, but the level of IL-6 and TNF-alpha in the observation group was significantly lower than that in the control group(P < 0.05). The scores of neurological deficit(NIHSS) in both groups were significantly lower 14 days after operation than before, but the improvement in the observation group was more obvious than that in the control group(P < 0.05). Conclusion Early minimally invasive removal of intracranial hematoma in the treatment of hypertensive intracerebral hemorrhage can effectively improve the clinical effect, reduce the level of inflammatory factors and significantly improve neurological function.
Objective To study the clinical effect of early minimally invasive intracranial hematoma removal in the treatment of hypertensive cerebral hemorrhage. Methods 88 patients with hypertensive intracerebral hemorrhage admitted to the hospital from May 2016 to April 2018 were divided into two groups by double blind method, including control group and observation group, 44 cases in each group. The control group was treated with small bone window hematoma removal, while the observation group was treated with early minimally invasive hematoma removal. The clinical efficacy of the two groups was compared. Results The total effective rate of the observation group after treatment was 93.18%, higher than that of the control group of 77.27%(P < 0.05). The levels of interleukin-6(IL-6) and tumor necrosis factor-alpha(TNF-alpha) at 7 and 14 days after operation in the two groups were significantly changed compared with those before operation, but the level of IL-6 and TNF-alpha in the observation group was significantly lower than that in the control group(P < 0.05). The scores of neurological deficit(NIHSS) in both groups were significantly lower 14 days after operation than before, but the improvement in the observation group was more obvious than that in the control group(P < 0.05). Conclusion Early minimally invasive removal of intracranial hematoma in the treatment of hypertensive intracerebral hemorrhage can effectively improve the clinical effect, reduce the level of inflammatory factors and significantly improve neurological function.
引文
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[2]魏栋辉.微创颅内血肿清除术治疗老年高血压脑出血的疗效观察[J].中国实用神经疾病杂志,2016,19(8):57-58.
[3]孙旭,杨东波,蒋传路,等.微创颅内血肿清除术治疗高血压性基底节区脑出血的临床疗效分析[J].哈尔滨医科大学学报,2013,47(2):164-167,170.
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[5]王建力.早期微创颅内血肿清除术治疗高血压脑出血的临床疗效及对患者血清炎症因子的变化[J].医药前沿,2016,6(28):201-202.
[6]吴修华,杜杰.微创颅内血肿清除术治疗高血压脑出血临床观察[J].山东大学学报(医学版),2014,52(z2):84,87.
[7]段国庆.早期微创颅内血肿清除术治疗高血压脑出血的效果及对CRP、IL-4、IL-10水平的影响[J].中国实用医刊,2018,45(7):67-70.
[8]徐岳峰.微创颅内血肿清除术治疗高血压性脑出血205例临床分析[J].中西医结合心脑血管病杂志,2014,12(4):510-511.
[9]韩凯.微创颅内血肿清除术治疗高血压脑出血的疗效观察[J].中国实用神经疾病杂志,2016,19(17):113.
[10]刘书考.微创颅内血肿清除术治疗高血压脑出血的临床疗效[J].心血管病防治知识,2017,24(7):12-14.
[11]张自豪,张文亮,刘叶,等.微创颅内血肿清除术对高血压脑出血患者的治疗作用及TCD评价[J].海南医学院学报,2017,23(6):837-840.
[12]陈修斌,万发波.微创血肿清除术治疗高血压脑出血的疗效及安全性[J].中国继续医学教育,2018,10(26):90-92.
[13]董灵军.微创颅内血肿清除术对高血压基底节区脑出血的治疗探讨[J].现代诊断与治疗,2015,26(16):3603-3605.
[2]魏栋辉.微创颅内血肿清除术治疗老年高血压脑出血的疗效观察[J].中国实用神经疾病杂志,2016,19(8):57-58.
[3]孙旭,杨东波,蒋传路,等.微创颅内血肿清除术治疗高血压性基底节区脑出血的临床疗效分析[J].哈尔滨医科大学学报,2013,47(2):164-167,170.
[4]孙永,孙辉,姚凯华,等.早期微创颅内血肿清除术治疗高血压脑出血100例的疗效分析[J].重庆医学,2013,42(21):2534-2536.
[5]王建力.早期微创颅内血肿清除术治疗高血压脑出血的临床疗效及对患者血清炎症因子的变化[J].医药前沿,2016,6(28):201-202.
[6]吴修华,杜杰.微创颅内血肿清除术治疗高血压脑出血临床观察[J].山东大学学报(医学版),2014,52(z2):84,87.
[7]段国庆.早期微创颅内血肿清除术治疗高血压脑出血的效果及对CRP、IL-4、IL-10水平的影响[J].中国实用医刊,2018,45(7):67-70.
[8]徐岳峰.微创颅内血肿清除术治疗高血压性脑出血205例临床分析[J].中西医结合心脑血管病杂志,2014,12(4):510-511.
[9]韩凯.微创颅内血肿清除术治疗高血压脑出血的疗效观察[J].中国实用神经疾病杂志,2016,19(17):113.
[10]刘书考.微创颅内血肿清除术治疗高血压脑出血的临床疗效[J].心血管病防治知识,2017,24(7):12-14.
[11]张自豪,张文亮,刘叶,等.微创颅内血肿清除术对高血压脑出血患者的治疗作用及TCD评价[J].海南医学院学报,2017,23(6):837-840.
[12]陈修斌,万发波.微创血肿清除术治疗高血压脑出血的疗效及安全性[J].中国继续医学教育,2018,10(26):90-92.
[13]董灵军.微创颅内血肿清除术对高血压基底节区脑出血的治疗探讨[J].现代诊断与治疗,2015,26(16):3603-3605.