经软通道微创治疗高血压脑出血的疗效观察及对血清白细胞介素18、血管内皮生长因子、C反应蛋白和肿瘤坏死因子α影响  

Observation of curative effect of soft channel minimally invasive treatment for hypertensive intracerebral hemorrhage and its influence on serum IL-18,VEGF,CRP and TNF-αin patients with hypertensive intracerebral hemorrhage

作　　者：黄龙 茅国兴[1] Huang Long;Mao Guoxing(Department of Neurosurgery,Taizhou Hospital of Traditional Chinese Medicine,Taizhou,Zhejiang 318000,China)

机构地区：[1]台州市中医院神经外科,浙江省318000

出　　处：《中国基层医药》2020年第7期850-854,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的:探讨经软通道微创治疗高血压脑出血的疗效及对患者血清白细胞介素18(IL-18)、血管内皮生长因子(VEGF)、C反应蛋白(CRP)和肿瘤坏死因子α(TNF-α)的影响。方法:选择台州市中医院2017年4月至2019年4月收治的高血压脑出血患者82例,依据随机数字表法分为观察组41例与对照组41例。对照组采用经硬通道微创治疗,观察组采用经软通道微创治疗。比较两组治疗疗效,术前和术后7 d颅内血肿量变化,术前和术后7 d血清IL-18、VEGF、CRP和TNF-α水平变化,术前和术后3个月神经功能缺损程度(NIHSS)评分变化,及术后并发症。结果:观察组总有效率(92.68%)高于对照组(70.73%)(χ 2=6.609, P<0.05);观察组术后7 d颅内血肿量(4.03±1.10)mL,低于对照组的(7.17±1.36)mL( t=11.495, P<0.05);观察组术后7d血清IL-18(123.74±10.27)ng/L、VEGF(113.28±12.10)ng/L、CRP(17.83±3.20)mg/L、TNF-α(0.65±0.12)ng/L,均低于对照组的(150.38±13.21)ng/L、(141.63±16.87)ng/L、(29.96±4.53)mg/L、(1.09±0.17)ng/L( t=11.638、9.101、13.831、5.569,均 P<0.05);观察组术后3个月NIHSS评分(16.53±3.19)分,低于对照组的(23.43±4.65)分( t=7.824, P<0.05);观察组并发症发生率(12.20%)低于对照组(34.15%)(χ 2=5.549, P<0.05)。 结论:软通道微创治疗高血压脑出血患者疗效良好,可降低血清IL-18、VEGF、CRP和TNF-α水平。Objective To investigate the effect of soft channel minimally invasive treatment on hypertensive intracerebral hemorrhage(HICH)and its influence on serum interleukin-18(IL-18),vascular endothelial growth factor(VEGF),C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α).Methods From April 2017 to April 2019,82 patients with HICH admitted to Taizhou Hospital of Traditional Chinese Medicine were randomly divided into observation group(41 cases)and control group(41 cases)according to random number table method.The control group was treated with hard channel minimally invasive treatment,while the observation group was treated with soft channel minimally invasive treatment.The therapeutic effect,intracranial hematoma volume,serum levels of IL-18,VEGF,CRP and TNF-αbefore and 7 days after operation,neurological deficit degree(NIHSS)scores before and 3 months after operation,and complications after operation were compared between the two groups.Results The total effective rate of the observation group(92.68%)was higher than that of the control group(70.73%)(χ2=6.609,P<0.05).The amount of intracranial hematoma in the observation group[(4.03±1.10)mL]was lower than that in the control group[(7.17±1.36)mL](t=11.495,P<0.05).At 7 d after operation,the serum levels of IL-18[(123.74±10.27)ng/L],VEGF[(113.28±12.10)ng/L],CRP[(17.83±3.20)mg/L]and TNF-α[(0.65±0.12)ng/L]in the observation group were lower than those in the control group[(150.38±13.21)ng/L,(141.63±16.87)ng/L,(29.96±4.53)mg/L and(1.09±0.17)ng/L](t=11.638,9.101,13.831,5.569,all P<0.05).The NIHSS score of the observation group[(16.53±3.19)points]was lower than that of the control group[(23.43±4.65)points]at 3 months after operation(t=7.824,P<0.05).The incidence of complications in the observation group(12.20%)was lower than that in the control group(34.15%)(χ2=5.549,P<0.05).Conclusion Soft channel minimally invasive treatment for HICH has good effect and can reduce the changes of serum levels of IL-18,VEGF,CRP and TNF-α.

关 键 词：颅内出血 高血压性 外科手术 微创性 软通道微创 硬通道微创 白细胞介素18 血管内皮生长因子 C反应蛋白 肿瘤坏死因子Α 

分 类 号：R54[医药卫生—心血管疾病] R651[医药卫生—内科学]