微创引流术与开颅术治疗老年高血压脑出血病人疗效及对相关蛋白因子水平的影响  

Effects of minimally invasive hematoma drainage or craniotomy on the levels of related protein factors and efficacy in the elderly patients with hypertensive intracerebral hemorrhage

作　　者：陈委[1] 叶宇[1] 欧阳锡华[1] 仪立志[1] 尹夕龙[1] 石小峰[1] CHEN Wei;YE Yu;OUYANG Xi-hua;YI Li-zhi;YIN Xi-long;SHI Xiao-feng(Department of Neurosurgery,Longgang Central Hospital,Shenzhen 518116,China)

机构地区：[1]深圳市龙岗中心医院神经外科,广东省深圳市518116

出　　处：《实用老年医学》2019年第5期480-483,共4页Practical Geriatrics

基　　金：深圳市龙岗区经济与科研发展专项资金--医疗卫生科技计划项目(201620436)

摘　　要：目的比较微创引流术与开颅术治疗老年高血压脑出血病人的疗效及对相关蛋白因子水平的影响。方法选取2015年3月至2017年3月我院收治的年龄>60岁的老年高血压脑出血病人100例,随机分为对照组与观察组,每组50例。对照组实施开颅术,观察组实施微创引流术。观察并比较2组病人术后疗效、格拉斯哥预后评分(GOS)、术后血肿残余量及治疗前后Tau蛋白、胶质纤维酸性蛋白(GFAP)、N末端脑钠肽前体(NTpro BNP)水平的变化。结果手术后,对照组治疗总有效率为72. 00%,观察组为92. 00%,2组比较差异有统计学意义(P<0. 05)。2组术后GOS评分与术前比较显著升高,术后血肿残余量、Tau蛋白、GFAP及NT-proBNP水平显著降低,差异均有统计学意义(P<0. 05);且观察组较对照组改变更明显,组间比较差异有统计学意义(P<0. 05)。结论微创引流术治疗老年高血压脑出血,可改善病人生活质量及再出血情况,降低相关蛋白因子水平,显著提高临床疗效。Objective To compare the effects of minimally invasive drainage or craniotomy on the levels of related protein factors and the efficacy in the elderly patients with hypertensive intracerebral hemorrhage.Methods A total of 100 elderly patients with hypertensive intracerebral hemorrhage aged over 60 years in our hospital from March 2015 to March 2017 were selected. The patients were randomly divided into the control group and the observation group,with 50 cases in each group. The patients in the control group were treated with craniotomy, and the patients in the observation group were treated with minimally invasive drainage. The clinical efficacy,the score of Glasgow outcome scale(GOS) and residual hematoma after operation,the levels of Tau protein, glial fibrillary acidic protein (GFAP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in two groups before and after the operation were observed and compared.Results After operation, the total effective rate was 72.00% in the control group, compared with 92.00% in the observation group( P < 0.05). After operation, the GOS score was significantly higher than that before operation, and the residual hematoma after operation, the levels of Tau protein, GFAP and NT-proBNP were significantly lower than those before operation( P < 0.05). The changes in the observation group were more obvious than those in the control group( P < 0.05).Conclusions Minimally invasive drainage in the treatment of elderly patients with hypertensive intracerebral hemorrhage can improve the quality of life and bleeding, reduce the levels of related protein factors, and significantly improve the clinical efficacy.

关 键 词：微创引流术 开颅术 高血压脑出血 蛋白因子 

分 类 号：R743.3[医药卫生—神经病学与精神病学]