不同手术方式治疗丘脑出血破入脑室患者手术前后炎症因子表达及预后观察  

THE INFLAMMATORY EXPRESSION AND THERAPEUTIC EFFECT RESEARCH IN DIFFERENT OPERATION TREATING HYPERTENSIVE WITH THALAMUS INTRAVENTRICULAR HEMORRHAGE

作　　者：袁淼[1] 翟安林[1] 王帆[1] 苟志勇[1] 

机构地区：[1]四川省绵阳四零四医院(川北医学院附属第二医院)神经外科,621000

出　　处：《中国煤炭工业医学杂志》2017年第11期1287-1290,共4页Chinese Journal of Coal Industry Medicine

基　　金：绵阳市卫生局课题(编号:201227)

摘　　要：目的探讨不同手术方式治疗丘脑出血破入脑室患者手术前后炎症因子表达、临床疗效及其预后。方法回顾分析我院神经外科2010年1月—2013年12月住院治疗高血压丘脑出血破入脑室患者60例,分为观察组和对照组;对照组采用双侧侧脑室钻孔引流术,观察组采用侧脑室三角区锁孔开颅血肿清除术;所有患者于术前、术后1d、2d、3d、1周、2周采集患者静脉血标本检测肿瘤坏死因子a(TNF-a)及C-反应蛋白(CRP);观察术后临床疗效及格拉斯哥预后评分(GOS)评分。结果 (1)两组患者术后TNF-a的表达均较术前降低,差异有统计学意义(P<0.05);两组间比较差异有统计学意义(P<0.05);(2)两组患者术后CRP的表达均较术前降低,差异有统计学意义(P<0.05);两组间比较差异有统计学意义(P<0.05);(3)术后观察组临床疗效优于对照组,两组间比较差异有统计学意义(P<0.05);(4)术后3个月随访,观察组患者GOS评分优于对照组(P<0.05)。结论侧脑室三角区锁孔开颅血肿清除术较侧脑室钻孔引流术能明显减轻体内炎症反应,提高临床疗效,改善患者预后。Objective To research the inflamrfiatory expression and therapeutic effect in different operation treating the hypertensive thalamus intraventricular hemorrhage.Methods A retrospective analysis was performed for 60 patients of hypertensive thalamus intraventricular hemorrhage in author＇sdepartment between January 2010 and December 2013; control group was operated through frontal transcortical approach, while experiment group was operated through lateral ventricle triangle.They were assessed according to the inflam- matory factor,the therapeutic effect and the Glasgow Outcome Scale （GOS）.Results TNF- a expressions reduced after the operation （P〈0.05） ,the difference between the two groups was significant （P〈0.05）.CRP expressions was also reduced after the operation （P〈0.05）, the difference between the two groups was significant （P〈0.05）.The therapeutic effect between the two groups was significant （P〈0.05）.The difference of GOS between the two groups was significant （P 〈 0.05）. Conclusion Craniotomy hematoma clearance through lateral ventricle triangle is effective in treating the hypertensive thalamus intraventricular hemorrhage which can reduce the inflammatory expression significantly.

关 键 词：脑室钻孔外引流 血肿清除术 丘脑出血 肿瘤坏死因子A C反应蛋白 格拉斯哥预后评分 

分 类 号：R651.10[医药卫生—外科学]