颅内血肿清除术与亚低温疗法治疗高血压脑出血临床观察  

Clinical observation of intracranial hematoma removal and mild hypothermia therapy for cerebral hemorrhage

作　　者：田洋洋 齐远[1] 张晶[1] TIAN Yangyang;QI Yuan;ZHANG Jing(The First Hospital of Jilin University,Changchun 130021,China)

机构地区：[1]吉林大学第一医院,吉林长春130021

出　　处：《中国实用神经疾病杂志》2021年第23期2064-2071,共8页Chinese Journal of Practical Nervous Diseases

摘　　要：目的分析颅内血肿清除术联合亚低温疗法对高血压脑出血患者血清炎症细胞因子、神经功能缺损程度及预后的影响。方法选取吉林大学第一医院94例高血压脑出血患者,对照组47例患者给予颅内血肿清除术,试验组47例患者给予颅内血肿清除术+亚低温疗法。比较2组治疗前后血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平、Brathel指数及美国国立卫生研究院卒中量表(NIHSS)评分。于治疗后8周评价2组患者格拉斯哥预后分级(GOS)情况。结果与治疗前相比,治疗后2周2组血清CRP和TNF-α水平均明显下降(P<0.05);与对照组相比,治疗后2周试验组血清CRP和TNF-α水平均明显下降(P<0.05)。与治疗前比较,治疗后8周2组Brathel指数均明显升高,NIHSS评分均明显下降(P<0.05);与对照组比较,治疗后8周试验组Brathel指数明显升高,NIHSS评分明显下降(P<0.05)。治疗后8周,2组GOS情况比较有明显差异(P<0.05)。结论颅内血肿清除术联合亚低温疗法不仅有效降低高血压脑出血患者促炎细胞因子水平,而且明显减轻患者神经功能缺损程度,改善预后情况,提高患者生活质量。Objective To analyze the effect of intracranial hematoma removal combined with mild hypo⁃thermia therapy on serum inflammatory cytokines,neurological deficiency and prognosis in patients with hyperten⁃sive intracerebral hemorrhage.Methods Totally 94 patients with hypertensive intracerebral hemorrhage were ran⁃domly divided into two groups,the control group was treated by intracerebral hematoma removal,and the experi⁃mental group was treated by intracerebral hematoma removal and mild hypothermia therapy.The levels of serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),Brathel index and National Institutes of Health stroke scale(NIHSS)scores before and after treatment were compared between the two groups.At 8 weeks after treat⁃ment,Glasgow outcome scale(GOS)was evaluated.Results Compared with before treatment,the serum CRP and TNF-αlevels of the two groups decreased significantly(P<0.05)and compared with the control group,the se⁃rum CRP and TNF-αlevels of the two groups decreased significantly(P<0.05).Compared with the control group,the Brathel index was significantly higher and the NIHSS score was significantly lower in the two groups 8 weeks after treatment(P<0.05);compared with the control group,the Brathel index was was significantly higher and the NIHSS score was significantly lower of the experimental group after 8 weeks of treatment(P<0.05).After 8 weeks of treatment,there was significant difference in GOS evaluation between the two groups(P<0.05).Conclusion It is not only effective to reduce the level of pro-inflammatory cytokines in patients with hypertensive intracerebral hemorrhage,but also to improve the neurological deficiency and prognosis,and increase quality of life.

关 键 词：高血压脑出血 亚低温疗法 颅内血肿清除术 炎症细胞因子 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]