微创锥颅立体定向软通道置管血肿引流术对高血压基底核区出血患者术后神经功能及血清炎性因子水平的影响

doi:10.3969/j.issn.1671-7171.2021.06.006

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摘要【目的】探讨微创锥颅立体定向软通道置管血肿引流术对高血压基底核区出血患者术后神经功能及血清炎性因子水平的影响。【方法】回顾性分析2018年6月至2020年6月本院收治的77例高血压基底核区出血患者的临床资料,根据手术方案分为传统组(行传统开颅术,n=38)和微创组(行微创锥颅立体定向软通道置管血肿引流术,n=39)。比较两组血肿清除率、并发症发生情况,对比手术前后血清炎性因子[肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)]、神经功能(NIHSS)、日常生活能力(ADL)。【结果】微创组血肿清除率优于传统组,差异有统计学意义(χ²=1.835,P=0.033＜0.05)。术后1周、1个月,两组血清TNF-α、PCT水平均低于术前,微创组均低于传统组,差异均有统计学意义(P<0.05)。术后3个月,两组NIHSS评分低于术前,ADL评分高于术前,微创组NIHSS、ADL评分差值高于传统组,差异均有统计学意义(P<0.05)。微创组并发症发生率为5.12%(2/39),低于传统组的23.68%(9/38),差异有统计学意义(χ²=5.412,P=0.02＜0.05)。【结论】微创锥颅立体定向软通道置管血肿引流术应用于高血压基底核区出血患者,可降低血清炎性因子水平,改善患者神经功能,有利于患者预后。

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关键词 ：颅内出血,高血压性/外科学, 基底神经节, 引流术, 最小侵入性外科手术

Abstract：【Objective】To investigate the effect of minimally invasive stereotactic soft channel hematoma drainage on postoperative neurological function and serum inflammatory factors in patients with hypertensive basal ganglia hemorrhage. 【Methods】The clinical data of 77 patients with hypertensive basal ganglia hemorrhage admitted to our hospital from June 2018 to June 2020 were retrospectively analyzed. According to the operation scheme, they were divided into traditional group (traditional craniotomy, n=38) and minimally invasive group (minimally invasive stereotactic soft channel hematoma drainage, n=39). The hematoma clearance rate and complications were compared between the two groups, TNF- α, Procalcitonin (PCT), nerve function (NIHSS) and activity of daily living (ADL) were measured.【Results】The hematoma clearance rate of minimally invasive group was better than that of traditional group, and the difference is statistically significant(χ²=1.835,P=0.033＜0.05). One week and one month after operation, TNF -αin the two groups, the PCT level was lower than that before operation, and the minimally invasive group was lower than that of the traditional group, and the difference was statistically significant (P<0.05). The difference of NIHSS and ADL scores in minimally invasive group was higher than that of the traditional group (P<0.05). The incidence of complications in minimally invasive group was 5.12% (2/39), which was lower than that of the traditional group (23.68% (9/38), and the difference was statistically significant(χ²=5.412,P=0.02＜0.05).【Conclusion】Minimally invasive stereotactic soft channel hematoma drainage in patients with hypertensive basal ganglia hemorrhage can reduce the level of serum inflammatory factors, improve the neurological function of patients, and is conducive to the prognosis of patients.

Key words： Intracranial Hemorrhage, Hypertensive/SU Basal Ganglia Drainage Minimally Invasive Surgical Procedures

收稿日期: 2021-01-05

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R743

通讯作者: *E-mail:305838834@qq.com

引用本文:

冯乐霄, 苏永永, 谢江涛, 向毅, 王世锋, 武兴兴. 微创锥颅立体定向软通道置管血肿引流术对高血压基底核区出血患者术后神经功能及血清炎性因子水平的影响[J]. 医学临床研究, 2021, 38(6): 824-826.
FENG Le-xiao, SU Yong-yong, XIE Jiang-tao, et al. Effect of Minimally Invasive Stereotactic Soft Channel Hematoma Drainage on Postoperative Neurological Function and Serum Inflammatory Factors in Patients with Hypertensive Basal Ganglia Hemorrhage. JOURNAL OF CLINICAL RESEARCH, 2021, 38(6): 824-826.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.06.006 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I6/824