锥颅血肿引流术治疗老年高血压性脑出血的临床研究  

Clinical Effect of Drilling Skull Drainage of Hematoma in Older Patients with Hypertensive Cerebral Hemorrhage

作　　者：王琨 张家伟 Wang Kun;Zhang Jiawei(Xianyang Hospital,Yan'an University,Xianyang 712000)

机构地区：[1]延安大学咸阳医院,咸阳712000

出　　处：《国际老年医学杂志》2021年第1期28-30,45,共4页International Journal of Geriatrics

摘　　要：目的探究老年高血压性脑出血(HCH)应用锥颅血肿引流术治疗的临床效果及血清白细胞介素6(IL-6)、超敏C反应蛋白(hs-CRP)、神经元特异性烯醇化酶(NSE)水平变化。方法回顾性分析2015年9月~2017年9月延安大学咸阳医院收治的97例老年HCH患者,按手术治疗方式分为观察组(锥颅血肿引流术)54例和对照组(开颅手术)43例。观察两组患者手术时间、住院时间、美国国立卫生院神经功能缺损评分(NIHSS),手术前后格拉斯哥结局量表(GOS)评分、脑残留血肿体积及颅内压,血清IL-6、hs-CRP和NSE水平,并记录患者并发症发生情况。结果观察组患者手术时间、住院时间及术后NIHSS评分均低于对照组(P<0.05)。与对照组相比,术后观察组患者GOS评分升高,脑残留血肿体积及颅内压减少,差异均有统计学意义(P<0.05)。术后观察组患者IL-6、hs-CRP、NSE水平均低于对照组(P<0.05)。观察组术后并发症发生率显著低于对照组(P<0.05)。结论老年HCH患者应用锥颅血肿引流术可缩短留院时间,改善血清炎性因子及NSE水平,降低并发症发生率。Objective To investigate the clinical effect of drilling skull drainage of hematoma in older patients with hypertensive cerebral hemorrhage(HCH)and the levels of serum interleukin-6(IL-6),high-sensitivity C reactive protein(hs-CRP)and neuron-specific enolase(NSE).Methods The retrospective study was conducted in 97 older patients with HCH treated in Xianyang Hospital of Yan'an University between September 2015 and September 2017.The patients were divided into the observation group(drilling skull drainage of hematoma,54 cases)and the control group(craniotomy,43 cases)according to the treatment method.The operation time,hospital stay,the National Institutes of Health Stroke Scale(NIHSS)scores,Glasgow Outcome Scale(GOS)scores,residual hematoma volume,intracranial pressure,serum levels of IL-6,hs-CRP and NSE in both groups before and after operation were documented.The incidence of complications was recorded.Results The operation time,hospital stay and postoperative NIHSS score in the observation group were significantly lower than those in the control group(P<0.05).The postoperative GOS score in the observation group was significantly higher,the residual hematoma volume and intracranial pressure were significantly less than those in the control group(P<0.05).The levels of IL-6,hs-CRP and NSE in the observation group were significantly lower than those in the control group after operation(P<0.05).The incidence of complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion The application of drilling skull drainage of hematoma in the treatment of patients with HCH might shorten the patients'hospital stay,improve the levels of serum inflammatory factors and NSE,and reduce the incidence of complications.

关 键 词：锥颅血肿引流术 老年 高血压性脑出血 血清炎性因子 神经元特异性烯醇化酶 

分 类 号：R651.1[医药卫生—外科学]