微创颅内血肿清除术联合亚低温治疗高血压脑出血的效果及对血管活性因子、日常生活活动能力的影响  

Effect of Minimally Invasive Intracranial Hematoma Evacuation Combined with Mild Hypothermia Treatment in the Treatment of Hypertensive Intracerebral Hemorrhage and Its Effect on Vasoactive Factors and Activities of Daily Living

作　　者：李德辉 郭东亮 LI De-hui;GUO Dong-liang(Department of Neurocritical Medicine,Beijing Chaoyang Integrated Traditional Chinese and Western Medicine Emergency Rescue Center,Beijing 100020,China)

机构地区：[1]北京朝阳中西医结合急诊抢救中心神经重症医学科,北京100020

出　　处：《临床误诊误治》2022年第9期97-101,共5页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨微创颅内血肿清除术联合亚低温治疗高血压脑出血的效果及对血管活性因子、日常生活活动能力的影响。方法选取2020年3月—2021年10月收治的高血压脑出血86例,据治疗方法不同分为观察组和对照组各43例。2组均在常规治疗基础上行微创颅内血肿清除术治疗,在此基础上观察组术后联合亚低温治疗。观察比较2组术后引流量及住院时间,治疗后4周临床疗效,治疗前及治疗后4周神经功能缺损程度评分(CSS),血清内皮素(ET)、血管升压素(AVP)水平及Barthel指数评定量表(BI)评分。结果观察组术后引流量少于对照组,住院时间短于对照组(P<0.01);观察组治疗后总有效率高于对照组(P<0.05);2组治疗后CSS评分均降低,且观察组低于对照组(P<0.01);2组治疗后ET、AVP均明显降低,且观察组低于对照组(P<0.01);2组治疗后BI评分均明显升高,且观察组高于对照组(P<0.01)。结论微创颅内血肿清除术联合亚低温疗法用于治疗高血压脑出血,可提高临床疗效,改善神经功能缺损程度及生活质量,减少术后引流量及缩短住院时间,并可降低血管活性因子含量。Objective To investigate the effect of minimally invasive intracranial hematoma evacuation combined with mild hypothermia therapy in the treatment of hypertensive intracerebral hemorrhage(HIH)and its effect on vasoactive factors and activities of daily living(ADL).Methods A total of 86 cases of HIH who were treated from March 2020 to October 2021 were selected and divided into observation group(n=43)and control group(n=43)according to different treatment methods.Both groups were treated with minimally invasive intracranial hematoma evacuation on the basis of conventional treatment.On this basis,the observation group was supplemented with mild hypothermia therapy after operation.The postoperative drainage volume and length of hospital stay,clinical efficacy at 4 weeks after treatment,neurological deficit score(CSS),serum endothelin(ET),vasopressin(AVP)levels and Barthel Index(BI)score before and at 4 weeks after treatment were observed and compared between the two groups.Results The postoperative drainage volume of observation group was less than that of control group,and the length of hospital stay was shorter than that of the control group(P<0.01).The total effective rate of observation group after treatment was higher than that of control group(P<0.05).CSS score was lower in both groups after treatment,and lower in the observation group than in control group(P<0.01).The ET and AVP of two groups were significantly decreased after treatment,and lower in the observation group than in the control group(P<0.01).The BI scoress of the two groups were significantly increased after treatment,which were higher in the observation group than in control group(P<0.01).Conclusion Minimally invasive intracranial hematoma evacuation combined with mild hypothermia therapy for the treatment of HIH can improve the clinical effect,the degree of neurological deficit and quality of life,reduce postoperative drainage and shorten the length of hospital stay,and can reduce the levels of vasoactive factors.

关 键 词：颅内出血 高血压性 颅内血肿清除术 亚低温治疗 术后引流量 内皮素 血管升压素 日常生活活动能力 

分 类 号：R651.1[医药卫生—外科学]