微创颅内血肿清除术治疗早期高血压脑出血的临床疗效
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摘要
目的探讨微创血肿穿刺术治疗早期高血压脑出血的临床疗效。方法将2014年1~12月我院收治的87例高血压脑出血患者随机分成观察组(44例)和对照组(43例),观察组采用早期微创血肿清除术治疗,而对照组采用小骨窗血肿清除术治疗。比较两组患者治疗后的临床疗效、血清炎症因子水平及神经功能缺损程度。结果观察组患者治愈率与总有效率显著高于对照组(P<0.05);观察组术后的IL-6、TNF-α水平均显著低于对照组(P<0.05)。观察组术后7 d与术后14 d的GCS评分均显著高于对照组(P<0.05)。结论早期应用微创颅内血肿清除术能减轻高血压、脑出血急性期炎症因子水平和神经功能缺损。
Objective To explore the clinical effect of minimally invasive hematoma aspiration in the treatment of early hypertensive intra cerebral hemorrhage(HICH). Methods A total of 87 patients with HICH were randomly divided into observation group(44 cases) and control group(43 cases). The observation group was treated with minimally invasive removal of intracranial hematomas, while the control group was treated with key hole evacuation of hematoma approach.The curative effect, inflammatory factors levels and glasgow coma scale score(GCS) were compared. Results The cure rate and total effective rate in observation group were significantly higher than those in control group(P<0.05). The levels of IL-6 and TNF-α in observation group after treatment were significantly lower than those in control group(P<0.05). The GCS score of observation group 7 d and 14 d after treatment were significantly higher than that in control group(P <0.05). Conclusion Treatment of minimally invasive evacuation of hematoma surgery for HICH can reduce level of inflammatory factors neurologic impairment in acute stage of cerebral hemorrhage.
Objective To explore the clinical effect of minimally invasive hematoma aspiration in the treatment of early hypertensive intra cerebral hemorrhage(HICH). Methods A total of 87 patients with HICH were randomly divided into observation group(44 cases) and control group(43 cases). The observation group was treated with minimally invasive removal of intracranial hematomas, while the control group was treated with key hole evacuation of hematoma approach.The curative effect, inflammatory factors levels and glasgow coma scale score(GCS) were compared. Results The cure rate and total effective rate in observation group were significantly higher than those in control group(P<0.05). The levels of IL-6 and TNF-α in observation group after treatment were significantly lower than those in control group(P<0.05). The GCS score of observation group 7 d and 14 d after treatment were significantly higher than that in control group(P <0.05). Conclusion Treatment of minimally invasive evacuation of hematoma surgery for HICH can reduce level of inflammatory factors neurologic impairment in acute stage of cerebral hemorrhage.
引文
[1]余伟,陈云卫,沈德彬.早期微创颅内血肿清除术在高血压脑出血治疗中的应用[J].深圳中西医结合杂志,2014,24(9):91-92.
[2]梁红斌.微创颅内血肿清除术与保守疗法治疗高血压脑出血的疗效比较[J].微创医学,2010,5(2):113-115.
[3]王米君,孙登江.高血压脑出血的微侵袭治疗[J].中国医药科学,2011,1(9):78-79.
[4]孙满江,徐胜,赵丽萍.高血压脑出血个体化手术治疗120例临床分析[J].医药论坛杂志,2012,33(7):70-71.
[5]姚江伟,李芸.小骨窗开颅血肿清除术治疗高血压脑出血102例[J].中国现代药物应用,2010,4(3):96.
[6]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点(1995)[J].临床和实验医学杂志,2013,12(7):559.
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[8]马爱金,郝冬琳,许元丰,等.微创治疗高血压脑出血的疗效观察[J].中国实用神经疾病杂志,2011,14(22):70-71.
[9]杨军,聂晓枫.早期应用微创颅内血肿清除术治疗高血压脑出血的临床疗效及对血清炎症因子水平的影响[J].河北医学,2014,20(10):1635-1638.
[10]孙永,孙辉,姚凯华.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.
[11]李健,刘玮,陆海,等.小骨窗与大骨瓣开颅血肿清除术治疗高血压脑出血疗效比较的Meta分析[J].中国循证医学杂志,2014,14(10):1210-1217.
[12]张雷雷,张璐,梁宏伟,等.微创穿刺术与小骨窗血肿清除术治疗高血压脑出血的临床对照研究[J].中国实用医药,2015,10(5):71-72.
[13]房晓勇.微创外科手术治疗高血压脑出血60例临床观察[J].疑难病杂志,2010,9(7):538-539.
[14]张博翔.早期微创颅内血肿清除术治疗高血压脑出血临床应用价值评析[J].现代诊断与治疗,2015,26(19):4494-4495.
[15]邓忠仁.微创置软管引流手术治疗高血压脑出血的临床研究[J].中国医药科学,2015,5(18):135-136,145.
[2]梁红斌.微创颅内血肿清除术与保守疗法治疗高血压脑出血的疗效比较[J].微创医学,2010,5(2):113-115.
[3]王米君,孙登江.高血压脑出血的微侵袭治疗[J].中国医药科学,2011,1(9):78-79.
[4]孙满江,徐胜,赵丽萍.高血压脑出血个体化手术治疗120例临床分析[J].医药论坛杂志,2012,33(7):70-71.
[5]姚江伟,李芸.小骨窗开颅血肿清除术治疗高血压脑出血102例[J].中国现代药物应用,2010,4(3):96.
[6]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点(1995)[J].临床和实验医学杂志,2013,12(7):559.
[7]李放治,范芳荣,刘蒲生.微创清除术治疗高血压脑出血[J].中华神经医学杂志,2003,2(4):289-290.
[8]马爱金,郝冬琳,许元丰,等.微创治疗高血压脑出血的疗效观察[J].中国实用神经疾病杂志,2011,14(22):70-71.
[9]杨军,聂晓枫.早期应用微创颅内血肿清除术治疗高血压脑出血的临床疗效及对血清炎症因子水平的影响[J].河北医学,2014,20(10):1635-1638.
[10]孙永,孙辉,姚凯华.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.
[11]李健,刘玮,陆海,等.小骨窗与大骨瓣开颅血肿清除术治疗高血压脑出血疗效比较的Meta分析[J].中国循证医学杂志,2014,14(10):1210-1217.
[12]张雷雷,张璐,梁宏伟,等.微创穿刺术与小骨窗血肿清除术治疗高血压脑出血的临床对照研究[J].中国实用医药,2015,10(5):71-72.
[13]房晓勇.微创外科手术治疗高血压脑出血60例临床观察[J].疑难病杂志,2010,9(7):538-539.
[14]张博翔.早期微创颅内血肿清除术治疗高血压脑出血临床应用价值评析[J].现代诊断与治疗,2015,26(19):4494-4495.
[15]邓忠仁.微创置软管引流手术治疗高血压脑出血的临床研究[J].中国医药科学,2015,5(18):135-136,145.