微创软通道穿刺引流术在高血压脑出血患者中的应用效果及对神经损伤的影响  

Application Effect of Minimal Invasive Soft Channel Puncture and Drainage in Patients with Hypertensive Cerebral Hemorrhage and Its Influence on Nerve Injury

作　　者：赖余柱 徐尉升 廖伟[2] LAI Yuzhu;XU Weisheng;LIAO Wei(Longnan First People’s Hospital,Jiangxi Province,Longnan 341700,China;不详)

机构地区：[1]江西省龙南市第一人民医院,江西龙南341700 [2]赣南医学院第一附属医院

出　　处：《中国医学创新》2022年第30期28-32,共5页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(202210884)。

摘　　要：目的:探究及分析微创软通道穿刺引流术在高血压脑出血患者中的应用效果及对神经损伤的影响。方法:选取2019年10月-2021年10月龙南市第一人民医院收治的80例高血压脑出血患者,依据随机数字表法将患者分为对照组(40例)和观察组(40例)。对照组进行小骨窗血肿清除治疗,观察组则进行微创软通道穿刺引流术治疗。比较两组血肿清除率、格拉斯哥预后评分(GOS)、不良反应发生情况、脑水肿情况、血清神经损伤指标[神经元特异性烯醇化酶(NSE)、S100B蛋白(S100B)及胶质纤维酸性蛋白(GFAP)]及Barthel指数。结果:两组血肿清除率比较,差异无统计学意义(P>0.05)。观察组预后良好率高于对照组,不良反应发生率低于对照组(P<0.05)。术前,两组血肿周围组织水肿体积、血肿侧扰动系数、NSE、S100B、GFAP、Barthel指数比较,差异均无统计学意义(P>0.05)。术后1、2周,观察组血肿周围组织水肿体积和血肿侧扰动系数均优于对照组(P<0.05)。术后1、2周,观察组NSE、S100B、GFAP均低于对照组(P<0.05)。术后1、3个月,观察组Barthel指数均优于对照组(P<0.05)。结论:微创软通道穿刺引流术在高血压脑出血患者中的应用效果相对较好,且有助于控制及改善患者的神经损伤,在高血压脑出血患者中的应用价值较高。Objective:To investigate and analyze the application effect of minimal invasive soft channel puncture and drainage in patients with hypertensive cerebral hemorrhage and its influence on nerve injury.Method:A total of 80 patients with hypertensive cerebral hemorrhage admitted to Longnan First People’s Hospital from October 2019 to October 2021 were selected,they were divided into control group(40 cases)and observation group(40 cases)according to the random number table method.The control group was treated with small bone window hematoma clearance,and the observation group was treated with minimal invasive soft channel puncture and drainage.The hematoma clearance rate,Glasgow outcome score(GOS),incidence of adverse reactions,cerebral edema,serum nerve injury indexes[neuron-specific enolase(NSE),S100B protein(S100B)and glial fibrillary acidic protein(GFAP)]and Barthel index were compared between the two groups.Result:There was no significant difference in hematoma clearance rate between the two groups(P>0.05).The good prognosis rate of the observation group was higher than that of the control group,and the incidence of adverse reactions of the observation group was lower than that of the control group(P<0.05).Before operation,there were no significant differences in the volume of edema around hematoma,hematoma side disturbance coefficient,NSE,S100B,GFAP and Barthel index between the two groups(P>0.05).At 1 and 2 weeks after operation,the volume of edema around hematoma and hematoma side disturbance coefficient of the observation group were better than those of the control group(P<0.05).At 1 and 2 weeks after operation,NSE,S100B and GFAP of the observation group were lower than those of the control group(P<0.05).At 1 and 3 months after operation,the Barthel indexes of the observation group were better than those of the control group(P<0.05).Conclusion:The application effect of minimal invasive soft channel puncture and drainage in patients with hypertensive cerebral hemorrhage is better,and it is more helpful to th

关 键 词：微创软通道穿刺引流术 高血压脑出血 神经损伤 

分 类 号：R651.12[医药卫生—外科学]