超声引导微创清除术治疗高血压脑出血的疗效及安全性分析  

Analysis on the efficacy and safety of ultrasound-guided minimally invasive surgery for patients with hypertensive intracerebral hemorrhage

作　　者：葛先立 焦红军[2] GE Xianli;JIAO Hongjun(The Second People's Hospital of Henan Province,Xinzheng 451100,China;The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]河南省第二人民医院,河南新郑451100 [2]郑州大学第二附属医院,河南郑州450003

出　　处：《中国实用神经疾病杂志》2019年第11期1210-1215,共6页Chinese Journal of Practical Nervous Diseases

摘　　要：目的 研究超声引导微创清除术治疗高血压脑出血(HCH)的疗效及安全性。方法 选取2016-10-2018-08河南省第二人民医院HCH患者92例,采用随机数字表法分为常规组(n=46)和超声组(n=46)。常规组采用常规血肿清除方法治疗,超声组采用超声引导微创清除术治疗。比较2组血肿清除率、预后情况、并发症发生情况、术前及术后3个月神经功能(NIHSS)、日常生活能力(ADL)、血清神经元特异性烯醇化酶(NSE)、超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)水平变化情况。结果 超声组血肿清除率[(82.34±4.37)%]高于常规组[(74.82±3.54)%](P<0.05);超声组恢复良好率[69.57%(32/46)]高于常规组[45.65%(21/46)](P<0.05);术后2周,2组血清NSE、hs-CRP、IL-6水平均低于术前,且超声组低于常规组(P<0.05);术后3个月,2组NIHSS、ADL分均优于术前,超声组NIHSS分低于常规组,ADL分高于常规组(P<0.05);超声组术后并发症总发生率[6.52%(3/46)]低于常规组[21.74%(10/46)](P<0.05)。结论 超声引导微创清除术治疗HCH,能显著提高血肿清除率,降低血清NSE、hs-CRP、IL-6水平,降低术后并发症发生率,从而进一步改善患者神经功能,提高患者日常生活能力,改善患者预后。Objective To study the efficacy and safety of ultrasound guided minimally invasive surgery for patients with hypertensive intracerebral hemorrhage (HCH). Methods From October 2016 to August 2018,92 patients with HCH in our hospital were enrolled and divided into the conventional group ( n =46) and the ultrasound group ( n =46) according to the random number table.The conventional group was treated with conventional hematoma evacuation,and the ultrasound group was treated with ultrasound guided minimally invasive surgery.Hematoma clearance,prognosis,complication,preoperative and postoperative 3 months of neurological function (NIHSS),daily living ability (ADL),serum neuron specific enolase (NSE),hypersensitivity Changes in C reactive protein (hs CRP) and interleukin 6 (IL 6) levels were compared. Results The hematoma clearance rate in the ultrasound group[(82.34±4.37)%]was higher than that in the conventional group[(74.82±3.54)%]( P <0.05).The recovery rate in the ultrasound group[69.57%(32/46)]was higher than that in the conventional group.[45.65%(21/46)]( P <0.05),2 weeks after surgery,serum NSE,hs CRP,IL 6 levels were lower than preoperative,and the ultrasound group was lower than the conventional group ( P <0.05).3 months after operation,the NIHSS and ADL scores of the two groups were better than that before surgery,and the NIHSS score of the ultrasound group was lower than that of the conventional group,and the ADL score was higher than that of the conventional group ( P <0.05).The overall incidence of disease[6.52%(3/46)]was lower than that of the conventional group[21.74%(10/46)]( P <0.05). Conclusion Ultrasound guided minimally invasive surgery for HCH can significantly improve hematoma clearance,reduce serum NSE,hs CRP,IL 6 levels and decrease the incidence of postoperative complications,thereby further improving neurological function and improving patients' daily living ability and improve the prognosis of patients.

关 键 词：高血压脑出血 超声引导微创清除术 血清NSE 炎性因子 神经功能 并发症 

分 类 号：R743.34[医药卫生—神经病学与精神病学]