颅内血肿穿刺术治疗高血压脑出血患者的时机选择及对血浆内皮素-1、细胞间黏附分子-1水平的影响  

Timing of intracranial hematoma puncture in the treatment of patients with hypertensive intracerebral hemorrhage and its influence on the levels of plasma endothelin-1 and intercellular adhesion molecule-1

作　　者：杨梅 阮超 YANG Mei;RUAN Chao(Neurology Department,Shangluo Central Hospital,Shangluo 726000,China)

机构地区：[1]商洛市中心医院神经内科,陕西商洛726000

出　　处：《临床医学研究与实践》2021年第28期87-90,共4页Clinical Research and Practice

摘　　要：目的研究颅内血肿穿刺术治疗高血压脑出血(HICH)患者的时机选择及对血浆内皮素-1(ET-1)、细胞间黏附分子-1(ICAM-1)水平的影响。方法选取2017年1月至2020年3月我院收治的140例HICH患者,根据发病至手术时间的不同将其分为超早期组(<6 h,n=40)、早期组(6~24 h,n=60)以及晚期组(>24 h,n=40)。比较三组的手术结果、预后情况、血流动力学以及血清学指标。结果超早期组和早期组的血肿完全清除率、预后良好率高于晚期组,住院时间短于晚期组(P<0.05);超早期组的再出血率高于早期组和晚期组(P<0.05)。治疗后,三组的PSV、Vm均升高,ET-1、ICAM-1、NSE水平均降低,且超早期组和早期组优于晚期组(P<0.05)。结论早期行颅内血肿穿刺术治疗HICH,血肿清除率高,再出血率低,有助于改善患者预后和ET-1、ICAM-1、NSE水平,恢复患者脑部血流灌注。Objective To study the timing of intracranial hematoma puncture in the treatment of patients with hypertensive intracerebral hemorrhage(HICH)and its influence on the levels of plasma endothelin-1(ET-1)and intercellular adhesion molecule-1(ICAM-1).Methods A total of 140 patients with HICH admitted in our hospital from January 2017 to March 2020 were selected and divided into ultra early group(<6 h,n=40),early group(6-24 h,n=60)and late group(>24 h,n=40)according to different time from onset to operation.The surgical results,prognosis,hemodynamics and serological indexes of the three groups were compared.Results The complete clearance rate of hematoma and good prognosis rate in the ultra early group and the early group were higher than those in the late group,and the hospital stay was shorter than that in the late group(P<0.05);the rebleeding rate in the ultra early group was higher than that in the early group and the late group(P<0.05).After treatment,PSV and Vm in the three groups increased,ET-1,ICAM-1 and NSE levels decreased,and those in the ultra early group and the early group were better than the late group(P<0.05).Conclusion Early intracranial hematoma puncture in the treatment of HICH has a high hematoma clearance rate and low rebleeding rate,which is helpful to improve the prognosis and the levels of ET-1,ICAM-1 and NSE,and restore the cerebral blood perfusion of patients.

关 键 词：高血压脑出血 颅内血肿穿刺术 治疗时机 内皮素-1 细胞间黏附分子-1 

分 类 号：R651.1[医药卫生—外科学]