脑梗塞溶栓治疗后继发脑出血的临床研究  

Clinical Study of Cerebral Hemorrhage After Thrombolytic Treatment of CereBral Infarction

作　　者：张永伟 ZHANG Yong-wei(Department of Neurology,Junan County People's Hospital,linyi,Shandong 276600)

机构地区：[1]莒南县人民医院神经内科,山东临沂276600

出　　处：《智慧健康》2020年第24期179-181,共3页Smart Healthcare

摘　　要：目的探究脑梗塞溶栓治疗后继发脑出血的具体情况,并对其治疗效果进行分析。方法选取2017年1月至2018年12月来我院就诊的100例脑梗塞溶栓治疗后继发脑出血的患者作为本次研究对象,按照随机数列法分为研究组与对照组各50例,对照组患者采取细孔钻颅血肿引流术进行治疗,研究组患者采用小骨窗血肿清除术进行治疗。比较两组患者术后并发症发生率、炎性因子水平、NIHSS评分、Rankin评分、oxLDL、TXB2和6-Keto-PGF1α水平。结果手术结束后,研究组患者的术后并发症发生率明显低于对照组患者,差异有统计学意义,组间有可比性(P<0.05);研究组者的炎性因子(超敏C反应蛋白、白细胞介素-8、肿瘤坏死因子α、白细胞介素-6)水平明显低于对照组,差异比较有统计学意义(P<0.05);研究组患者的NIHSS评分低于对照组(P<0.05),且两组患者的Rankin评分无明显差异(P>0.05),但均优于治疗前(P<0.05);研究组患者的6-Keto-PGF1α水平高于对照组,但oxLDL、TXB2水平低于对照组(P<0.05)。结论针对于脑梗塞溶栓治疗后继发脑出血患者而言,使用小骨窗血肿清除术能够有效提升患者的治疗效果和减少术后并发症的发生率;降低超敏C反应蛋白水平、白细胞介素-8水平、肿瘤坏死因子α水平以及白细胞介素-6水平,同时对患者的血液指标具有明显的改善效果,值得推广应用。Objective to explore specific situation of cerebral hemorrhage secondary to thrombolytic treatment of cerebral infarction,analyze treatment effect.Methods choose 100 cases cerebral hemorrhage patients after cerebral infarction thrombolytic therapy in our hospital from January 2017 to December 2018 as research objects,divided them into study group and control group according to random number sequence method,50 cases in each group.Control group was treated with fine-hole drilling cranial hematoma drainage,and study group with small bone window hematoma removal.Compare Incidence of postoperative complications,levels of inflammatory factors,NIHSS scores,Rankin scores,oxLDL,TXB2 and 6-Keto-PGF1αlevels between two groups.Results after operation,incidence of postoperative complications in study group was significantly lower than control group,difference was statistically significant between two groups,(P<0.05);inflammatory factors(hypersensitivity)of study group,including levels of C-reactive protein,interleukin-8,tumor necrosis factor alpha,and interleukin-6,were significantly lower than control group,difference was statistically significant(P<0.05);NIHSS scores of study group were lower than control group(P<0.05),Rankin scores between two groups were not significantly different(P>0.05),both were better than before treatment(P<0.05);6-Keto-PGF1αlevel of study group was higher than control group,levels of oxLDL and TXB2 were lower than control group(P<0.05).Conclusion small bone window hematoma removal can effectively improve treatment effect of cerebral infarction patients with secondary cerebral hemorrhage after thrombolytic treatment,reduce incidence of postoperative complications;lower levels of hypersensitive C-reactive protein and interleukin of cytokine-8,tumor necrosis factorαand interleukin-6,at the same time,can achieve significant improvement effect on blood indicators,which is worthy of promotion and application.

关 键 词：脑梗塞 继发脑出血 细孔钻颅血肿引流术 小骨窗血肿清除术 

分 类 号：R743.3[医药卫生—神经病学与精神病学]