摘要
目的:观察内镜下微创手术对高血压脑出血(HICH)神经功能、日常生活能力、炎症应激反应的影响.方法:采用随机数字表法将我院2022年1月至2024年7月期间收治的110例HICH患者分为对照组(n=55,软通道穿刺抽吸引流术)和观察组(n=55,内镜下微创手术).对比两组血肿量、血肿清除率、神经功能[神经元特异性烯醇化酶(NSE)、美国国立卫生研究院卒中量表(NIHSS)、神经肽Y(NPY)、纳维亚卒中量表(SSS)、脑源性神经营养因子(BDNF)]、炎症因子水平[肿瘤坏死因子-α(TNF-α)、白细胞计数(WBC)、降钙素原(PCT)、C反应蛋白(CRP)]和应激指标[皮质醇(Cor)、内皮素(ET)、促肾上腺皮质激素(ACTH)、血管生成素-1(Ang-1)]和日常生活活动能力(ADL)评分.结果:观察组术后3d血肿量、NSE、NIHSS评分、TNF-α、PCT、CRP、WBC、Cor、Ang-1、ACTH、ET低于对照组;SSS、NPY、BDNF、血肿清除率高于对照组(P<0.05).观察组术后3个月ADL评分高于对照组(P<0.05).结论:内镜下微创手术应用于HICH,可有效降低炎症、应激反应,减轻神经功能损伤,改善日常生活活动能力.
Objective:To observe the effect of minimally invasive operation under endoscopy on neurological function,daily living ability,inflammatory stress response of hypertensive intracerebral hemorrhage(HICH).Methods:110 HICH patients who were admitted to our hospital from January 2022 to July 2024 were divided into control group(n=55,soft channel puncture suction flow)and an observation group(n=55,minimally invasive surgery under endoscopic)by using random number table method.The hematoma volume,hematoma clearance rate,and neurological function[neuron specific enolase(NSE),National Institutes of Health Stroke Scale(NIHSS),neuropeptide Y(NPY),Scandinavian Stroke Scale(SSS),brain-derived neurotrophic factor(BDNF)],inflammatory factor levels[tumor necrosis factor-α(TNF-α),white blood cell count(WBC),procalcitonin(PCT),C-reactive protein(CRP)]and stress indexes[cortisol(Cor),endothelin(ET),adrenocorticotropic hormone(ACTH),angiopoietin-1(Ang-1)]and activities of daily living(ADL)scores were compared between two groups.Results:Hematoma volume,NSE,NIHSS scores,TNF-α,PCT,CRP,WBC,Cor,Ang-1,ACTH,ET in observation group at 3 d after operation were lower than those in control group,SSS,NPY,BDNF,hematoma clearance rate was higher than those in control group(P<0.05).ADL score in the observation group was higher than that in the control group at 3 months after operation(P<0.05).Conclusion:Compared with soft channel puncture suction flow,HICH treat with minimally invasive surgery under endoscopic,which can reduce neurological function damage,decrease inflammatory stress response,and further improve activities of daily living.
作者
王大方
刘宇驰
赵伟
WANG Da-fang;LIU Yu-chi;ZHAO Wei(Department of Neurosurgery,Suzhou Integrated Traditional Chinese and Western Medicine Hospital,Suzhou,Jiangsu,215000,China)
出处
《现代生物医学进展》
2025年第4期720-728,共9页
Progress in Modern Biomedicine
关键词
内镜下微创手术
高血压脑出血
神经功能
炎症反应
应激反应
日常生活活动能力
Minimally invasive surgery under endoscopic
Hypertensive intracerebral hemorrhage
Neurological function
Inflammatory response
Stress response
Daily living ability
