神经内镜下经外侧裂入路血肿清除术对高血压脑出血患者炎症因子、预后及血清MMP-9、GM-CSF的影响  

Effects of Neuroendoscopic Translateral Fissure Approach Hematoma Evacuation on Inflammatory Factors,Prognosis,Serum MMP-9 and GM-CSF in Patients with Hypertensive Intracerebral Hemorrhage

作　　者：魏小兵[1] 温一奇 李素美 胡永珍 刘洋[1] 龙青山[1] 黄楚涛 刘惜弟 WEI Xiaobing;WEN Yiqi;LI Sumei;HU Yongzhen;LIU Yang;LONG Qingshan;HUANG Chutao;LIU Xidi(The Third People's Hospital of Huizhou,Guangdong Province,Huizhou 516000,China)

机构地区：[1]广东省惠州市第三人民医院,广东惠州516000

出　　处：《中国医学创新》2023年第8期5-9,共5页Medical Innovation of China

基　　金：2021年度惠州市科技研发计划项目(2021WC0106154)。

摘　　要：目的:探索神经内镜下经外侧裂入路血肿清除术对高血压脑出血患者炎症因子、预后及血清粒细胞-巨噬细胞集落刺激因子(GM-CSF)、基质金属蛋白酶-9(MMP-9)水平的影响。方法:前瞻性选取惠州市第三人民医院的97例高血压脑出血患者均在2017年2月-2022年2月收治,采用非随机对照法,根据手术方法分为两组,运用小骨窗开颅血肿清除术治疗的48例为对照组,运用神经内镜下经外侧裂入路血肿清除术治疗的49例为观察组,比较两组手术效果。结果:观察组术后7 d的肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)、MMP-9、GM-CSF水平及预后整体改善情况均优于对照组(P<0.05),手术时间、下床活动时间、住院时间均短于对照组(P<0.05),血肿清除率、日常生活能力评分量表(ADL)评分均高于对照组(P<0.05),术中出血量、术后血肿量均少于对照组(P<0.05),术后并发症发生率、神经功能缺损量表(NIHSS)评分均低于对照组(P<0.05)。结论:对高血压脑出血患者实施神经内镜下经外侧裂入路血肿清除术治疗,可提高血肿清除率,改善预后。Objective:To explore the effect of translateral fissure approach hematoma eva,uation on inflammatory factors,prognosis and serum granulocyte-macrophage colony-stimulating factor(GM-CSF),matrix metalloproteinase-9(MMP-9)levels.Method:A total of 97 patients with hypertensive intracerebral hemorrhage from the Third People's Hospital of Huizhou who were treated from February 2017 to February 2022 were prospectively selected.They were divided into two groups according to the surgical method using a non randomized control method,48 patients were treated with small bone window craniotomy hematoma clearance as the control group,and 49 patients were treated with translateral fissure approach hematoma clearance as the observation group,the results of operation were compared between the two groups.Result:The levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C reactive protein(CRP),MMP-9,GM-CSF and overall improvement of prognosis in the observation group were better than those in the control group 7 days after surgery(P<0.05),the time of operation,the time of getting out of bed and the time of hospitalization were shorter than those of control group(P<0.05),the hematoma clearance rate and the score of ADL were higher than those of control group(P<0.05),and the amount of intraoperative blood loss and postoperative hematoma volume were lower than those of control group(P<0.05),the postoperative complication rate and NIHSS score were lower than those of control group(P<0.05).Conclusion:Neuroendoscopic transsylvian approach for hematoma evacuation in patients with hypertensive intracerebral hemorrhage can improve the hematoma clearance rate and prognosis.

关 键 词：神经内镜 经外侧裂入路 血肿清除术 高血压脑出血 炎症因子 预后 

分 类 号：R651.1[医药卫生—外科学]