脑立体定向锥颅穿刺治疗高血压脑深部中量出血的效果研究  

Study on the effect of stereotactic brain puncture in the treatment of hypertensive deep brain hemorrhage

作　　者：罗云辉 LUO Yun-hui(Department of Neurosurgery,Nanchang 334 Hospital,Jiangxi Province,Nanchang 330000,China)

机构地区：[1]江西省南昌三三四医院神经外科,江西南昌330000

出　　处：《中国当代医药》2021年第30期52-54,57,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(20204098)。

摘　　要：目的研究脑立体定向锥颅穿刺治疗高血压脑深部中量出血的效果。方法选取2017年1月至2020年1月南昌三三四医院收治的78例高血压脑深部中量出血患者,按照随机数字表法分为对照组(n=39)和试验组(n=39)。对照组接受内科保守治疗,试验组接受脑立体定向锥颅穿刺颅内血肿抽吸引流术治疗。比较两组患者的手术相关指标、术前及术后3个月神经功能、术后血清C反应蛋白(CRP)及术后并发症。结果试验组手术及住院时间均短于对照组,住院费用少于对照组,血肿清除率高于对照组,差异有统计学意义(P<0.05)。术后3个月,两组患者格斯拉哥昏迷评分(GCS)、格斯拉哥预后评分(GOS)均高于本组术前,且试验组高于对照组,差异有统计学意义(P<0.05)。试验组术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。试验组术后血清CRP水平低于对照组,差异有统计学意义(P<0.05)。结论脑立体定向锥颅穿刺治疗可有效提高高血压脑深部中量出血患者的血肿清除率,改善神经功能,同时降低血清CRP水平,减轻机体炎症反应,促进患者术后恢复,安全性高。Objective To study the effect of stereotactic brain puncture in the treatment of hypertensive deep brain hemorrhage.Methods A total of 78 cases of hypertensive patients with hypertensive deep brain hemorrhage in Nanchang 334 Hospital from January 2017 to January 2020 were selected and randomly divided into control group(n=39)and test group(n=39).The control group received medical conservative treatment,and the test group received stereotactic intracranial hematoma aspiration.The operation-related indicators,preoperative and 3 months postoperative neurological function,postoperative serum C-reactive protein(CRP)and postoperative complications were compared between the two groups.Results The operation and hospitalization time of the experimental group was shorter than that of the control group,the hospitalization cost was less than that of the control group,and the hematoma clearance rate was higher than that of the control group,the differences were statistically significant(P<0.05).At 3 months after surgery,the Guslago coma scores(GCS)and the Guslago prognosis scores(GOS)of the two groups were higher than those before the operation,and the test group was higher than the control group,the differences were statistically significant(P<0.05).The incidence of postoperative complications in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05).The postoperative serum CRP level of the experimental group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Stereotactic craniopuncture can effectively improve the hematoma clearance rate,improve the neurological function,reduce the serum CRP level,reduce the inflammatory reaction,and promote the postoperative recovery of patients with hypertensive deep brain hemorrhage.

关 键 词：脑深部 中量出血 高血压 脑立体定向锥颅穿刺 临床疗效 

分 类 号：R544.1[医药卫生—心血管疾病]