手术时机及方式对重症高血压脑出血合并肺部感染患者的影响  

Effects of operation time and mode in patients with cerebral hemorrhage complicated with pulmonary infection

作　　者：张丙辰[1] 袁杰[1] 周俊 吕远 

机构地区：[1]钟祥市人民医院,湖北钟祥431900

出　　处：《中国实用神经疾病杂志》2017年第24期55-58,共4页Chinese Journal of Practical Nervous Diseases

基　　金：湖北省教育厅中青年人才项目;编号:Q20161111

摘　　要：目的探讨手术时机及手术方式选择在重症高血压脑出血合并肺部感染患者中的临床治疗效果及对血清hsCRP、IGF-1及Tau蛋白的影响。方法选取2015-12—2017-01钟祥市人民医院收治的重症高血压脑出血合并肺部感染患者60例,根据手术时机分为超早期组(n=13,<7h)、早期手术组(n=31,8~24h)及晚期治疗组(n=16,>24h);根据手术方式不同分为小骨窗显微手术组(n=29)和大骨瓣血肿清除术(n=31),各组患者均给予相应的手术治疗。结果超早期组CSS及NIHSS评分,均低于早期手术组和晚期治疗组(P<0.05);早期手术组CSS及NIHSS评分,均低于晚期治疗组(P<0.05);超早期组MMSE评分,高于早期手术组和晚期治疗组(P<0.05);早期手术组MMSE评分,高于早期治疗组(P<0.05);小骨窗显微手术组术后CSS、NIHSS评分,均低于大骨瓣血肿清除术组(P<0.05);小骨窗显微手术组术后MMSE评分,高于大骨瓣血肿清除术组(P<0.05);小骨窗显微手术组术后血清hs-CRP、IGF-1及Tau蛋白水平,均低于大骨瓣血清清除术组(P<0.05)。结论重症高血压脑出血合并肺部感染患者超早期选择小骨窗显微血肿清除术效果理想,值得应用。Objective To investigate the effect of surgical timing and mode of operation on the treatment of severe hyper-tensive intracerebral hemorrhage complicated with pulmonary infection and the effects of serum hs-CRP ,IGF-1 and Tau protein . Methods 60 patients with pulmonary infection from December 2015 to May 2017 admitted to the hospital with severe hyperten-sion cerebral hemorrhage were divided into ultra-early group （n=13 ,〈7 h） ,early surgery group （n=31 ,8-24h） and late treat-ment group （n=16 ,〉24 h） according to the timing of surgery .according to the operation mode ,patients were divided into small bone window microsurgery group （n=29 cases） and serum bone flap dissection （n=31） ,all patients were given the appropriate surgical treatment .Results CSS and NIHSS scores in the ultra-early group were lower than those of the early surgery group and late treatment group （P〈0.05）;CSS and NIHSS scores in the early surgery group were lower than the late treatment group （P〈0.05）;MMSE score of the ultra-early group was higher than that of the early surgery group and late treatment group （P〈0.05）;MMSE score in the early surgery group was higher than the early treatment group （P〈0.05）;The CSS ,NIHSS scores in the small bone window microsurgery group were lower than the big bone flap dissection serum group （P〈0.05）;the postoperative MMSE score of small bone window group was higher than that of large bone flap dissection group （P〈0.05）;the postoperative serum hs-CRP ,IGF-1 and Tau protein levels in the small bone window microsurgery group were lower than the big bone flap dis-section serum group （P〈0.05） .Conclusion The early removal of small bone window hematoma microsurgery for severe hyper-tensive intracerebral hemorrhage complicated with pulmonary infection is ideal and worthy of popularization and application

关 键 词：重症高血压脑出血 肺部感染 手术时机 手术方式 酶联免疫吸附试验 

分 类 号：R743.34[医药卫生—神经病学与精神病学]