摘要
目的探讨神经内镜下经外侧裂入路血肿清除术对高血压脑出血(HICH)患者神经功能、炎症因子和预后的影响。方法回顾性分析我院收治的80例HICH患者的临床资料,根据是否采用神经内镜辅助分为A组和B组。A组38例患者给予经外侧裂入路血肿清除术,B组42例患者给予神经内镜下经外侧裂入路血肿清除术。比较2组患者的神经功能、手术指标、炎症因子和预后。结果B组术中出血量少于A组,血肿清除率高于A组,手术时间短于A组,差异均有统计学意义(P<0.05)。2组术后1 d白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)及C反应蛋白(CRP)水平均较术前升高(P<0.05),但B组低于A组(P<0.05)。2组术后1 d神经元特异性烯醇化酶(NSE)、神经营养因子(NF)、S100B蛋白水平及神经功能缺损程度评分(NDS)较术前均降低(P<0.05),且B组低于A组(P<0.05)。B组预后良好率高于A组(P<0.05),2组病死率比较差异无统计学意义(P>0.05)。结论神经内镜下经外侧裂入路血肿清除术治疗HICH患者,手术效果好,术后机体炎性应激反应较小,可有效减轻患者神经功能损伤,患者预后佳。
Objective To investigate the effects of neuroendoscopic hematoma removal via lateral fissure approach on neurological function,inflammatory factors and prognosis of patients with hypertensive intracerebral hemorrhage(HICH).Methods The clinical data of 80 patients with HICH admitted to our hospital were retrospectively analyzed,and they were divided into group A and group B according to whether they were assisted by neuroendoscopy.A total of 38 patients in group A were treated with hematoma removal via lateral fissure approach,and 42 patients in group B were treated with neuroendoscopic hematoma removal via lateral fissure approach.The neurological function,operation indexes,inflammatory factors and prognosis of patients between the two groups were compared.Results The intraoperative blood loss of group B was less than that of group A,the clearance rate of hematoma was higher than that of group A,and the operation time was shorter than that of group A,the differences were statistically significant(P<0.05).The levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),procalcitonin(PCT)and C-reactive protein(CRP)1 day after operation in the two groups were higher than those before the operation(P<0.05),but which in group B were lower than those in group A(P<0.05).The levels of neuron specific enolase(NSE),neurotrophic factors(NF),S100B protein and the neurological deficit score(NDS)1 day after operation in the two groups were lower than those before the operation(P<0.05),and which in group B were lower than those in group A(P<0.05).The good prognosis rate of group B was higher than that of group A(P<0.05).There was no statistically significant difference in fatality rate between the two groups(P>0.05).Conclusion Neuroendoscopic hematoma removal via lateral fissure approach has a good surgical effect for patients with HICH,with less postoperative inflammatory stress response of the body,which can effectively reduce the neurological damage of patients,and the patients have a good prognosis.
作者
蒋耀峰
沈洋
董誉
王立
李元洋
JIANG Yao-feng;SHEN Yang;DONG Yu;WANG Li;LI Yuan-yang(Department of Neurosurgery,Nanjing Integrated Traditional Chinese and Western Medicine Hospital,Nanjing University of Chinese Medicine,Nanjing Jiangsu 210014,China)
出处
《局解手术学杂志》
2021年第6期494-497,共4页
Journal of Regional Anatomy and Operative Surgery
基金
江苏省自然科学基金青年科技人才专项(BK20161491)。
关键词
经外侧裂入路
血肿清除术
神经内镜
高血压脑出血
神经功能
炎症因子
预后
lateral fissure approach
hematoma removal
neuroendoscopy
hypertensive intracerebral hemorrhage
neurological function
inflammatory factors
prognosis
