高血压脑出血神经外科手术后癫痫发作的影响因素分析  

Influencing factors analysis of postoperative seizures in hypertensive intracerebral hemorrhage after Department of neurosurgery operation

作　　者：唐忠[1] 陈启富[1] 廖广生 陈思 陈静瑜[2] TANG Zhong;CHEN Qi-fu;LIAO Guang-sheng;CHEN Si;CHEN Jing-yu(Department of Neurosurgery,the Third People＇s Hospital of Shenzhen City,Guangdong Province,Shenzhen 518112,China;Department of Thoracic Surgery,People＇s Hospital of Wuxi City in Jiangsu Province,Wuxi 214023,China)

机构地区：[1]深圳市第三人民医院神经外科,广东深圳518112 [2]江苏省无锡市人民医院胸外科,江苏无锡214023

出　　处：《中国当代医药》2018年第25期81-83,96,共4页China Modern Medicine

基　　金：广东省深圳市"医疗卫生三名工程"资助项目(SZS M201812058)

摘　　要：目的探讨高血压脑出血神经外科手术后癫痫发作的影响因素。方法回顾性分析2016年5月~2017年10月在深圳市第三人民医院神经外科行手术治疗的58例高血压脑出血患者的诊疗情况。按照术后是否癫痫发作分为两组,其中17例术后癫痫发作患者作为观察组,41例术后无癫痫发作患者作为对照组。观察两组患者术后的神经元特异性烯醇化酶(NSE)、炎症因子水平,并对患者的临床特点进行比较分析。结果两组患者的年龄和性别比较,差异无统计学意义(P>0.05);两组患者的血肿体积、血肿位置、术后再出血及手术方式比较,差异有统计学意义(P<0.05);术后,观察组的肿瘤坏死因子-α(TNF-α)、血清白细胞介素-6(IL-6)、C-反应蛋白(CRP)、NES水平明显高于对照组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,血肿位置、血肿体积、术后再出血情况及机体内血清炎症因子TNF-α、IL-6、CRP、NSE等都是作为高出血脑出血后癫痫发作的独立危险因素(P<0.05)。结论血肿位置、血肿体积、手术方式等都是脑出血后早发性癫痫发生的独立危险性因素,在临床中应进行密切关注。Objective To explore the influencing factors of postoperative seizures after Department of Neurosurgery operation for hypertensive intracerebral hemorrhage. Methods A total of 58 cases of patients with hypertensive intracerebral hemorrhage of diagnosis treated in Department of Neurosurgery, the Third People′s Hospital of Shenzhen City from May 2016 to October 2017 were retrospective analyzed. They were divided into two groups according to whether they were epileptic seizures after operation. Among them, 17 patients with postoperative seizures were selected as the observation group, and 41 patients without seizures were used as control group. The levels of NSE and inflammatory factors in the two groups were observed, and their clinical characteristics were statistically analyzed. Results There were no significant difference in age and sex between the two groups（P〈0.05）. The hematoma volume, hematoma location, postoperative rebleeding and operative mode between the two groups were significant differences（P〈0.05）. After operation,the levels of TNF-α, IL-6, CPR and NES in the observation group were significantly higher than those in the control group, and the differences were statistically significant（P〈0.05）. The results of multiple factor Logistic regression analysis showed that the position of hematoma, hematoma volume, and postoperative rebleeding, including serum inflammatory factor TNF-α, IL-6, CPR, NSE were independent risk factors for epileptic seizures after high hemorrhage of cerebral hemorrhage（P〈0.05）. Conclusion The location of hematoma, hematoma volume and operation mode are independent risk factors for early onset epilepsy after intracerebral hemorrhage, and should be paid close attention in clinical practice.

关 键 词：高血压脑出血 癫痫发作 神经元特异性烯醇化酶 炎症因子 

分 类 号：R743.34[医药卫生—神经病学与精神病学]