摘要
目的探讨微创穿刺血肿清除术对高血压脑出血(HICH)患者血清铁蛋白(SF)、神经特异性烯醇化酶(NSE)及高敏C反应蛋白(Hs-CRP)水平的影响。方法回顾性选取2017年6月~2019年6月如皋市人民医院142例HICH患者,按治疗方法分为穿刺组(95例,给予微创穿刺血肿清除术)和手术组(47例,给予小骨窗血肿清除术),对比两组手术疗效及并发症情况,观察治疗前后患者神经功能缺损评分(NIHSS)、日常生活能力评分(MRS)和血清SF、NSE、Hs-CRP水平差异。结果穿刺组手术时间、术中出血量、住院时间及并发症发生率均小于手术组,而血肿清除率和治疗总有效率则显著高于手术组,差异有统计学意义(P<0.05)。穿刺组患者术后NIHSS评分、MRS评分、周围水肿量均明显小于手术组,差异有统计学意义(P<0.05)。两组患者术后血清SF、NSE、Hs-CRP水平呈明显降低趋势,且穿刺组均低于手术组,差异有统计学意义(P<0.05)。结论微创穿刺血肿清除术治疗HICH较小骨窗血肿清除术更为安全有效,有助于改善患者神经功能状况。
Objective To investigate the effect of minimally invasive hematoma removal on serum ferritin(SF),neuro-specific enolase(NSE)and high sensitivity C-reactive protein(Hs-CRP)levels in patients with hypertensive intracerebral hemorrhage(HICH).Methods 142 HICH patients were divided into puncture group(95 patients received minimally invasive puncture hematoma removal surgery)and operation group(47 patients received small bone window hematoma removal surgery).The efficacy and complications of the two groups were compared.The differences in National institutes of health neurological impairment score(NIHSS),modified rankin scale(MRS),and serum SF,NSE and Hs-CRP levels before and after treatment were observed.Results The operation time,intraoperative blood loss,hospital stay and complication rate of the puncture group were all lower than those of operation group,while the hematoma clearance rate and total effective rate of treatment were significantly higher than those of operation group(P<0.05).After 2 weeks of treatment,NIHSS score,MRS score and peripheral edema in the puncture group were significantly lower than those in the operation group(P<0.05).The serum SF,NSE and HS-CRP levels of the two groups were significantly reduced after surgery,and the puncture group was lower than the operation group(P<0.05).Conclusion Compared with small bone window hematoma removal surgery,minimally invasive hematoma removal surgery for HICH is safer and more effective.It is helpful to improve the neurological function of patients.
作者
夏越
陈兰
邹明宏
Xia Yue;Chen Lan;Zou Minghong(Intensive Care Medicine,Rugao People's Hospital,Nantong 226500,China)
出处
《中华保健医学杂志》
2020年第6期583-586,共4页
Chinese Journal of Health Care and Medicine
基金
南通市市级科技计划项目(MSZ19078)。
关键词
高血压脑出血
微创穿刺术
小骨窗
神经功能
Hypertensive intracerebral hemorrhage
Minimally invasive puncture
Small bone window
Nerve function
