脑出血不同时机行微创血肿清除术对患者神经功能及氧化应激的影响  

Effects of minimally invasive hematoma removal at different times on neurological function and oxidative stress in patients with intracerebral hemorrhage

作　　者：丁晨[1] 赵鑫[1] 王小雪 梁馨之[1] 解霞 DING Chen;ZHAO Xin;WANG Xiaoxue;LIANG Xinzhi;XIE Xia(The First Affiliated Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院,辽宁沈阳110001

出　　处：《陕西医学杂志》2023年第5期571-574,595,共5页Shaanxi Medical Journal

基　　金：辽宁省教育厅科学研究经费资助项目(FWZR2020004)。

摘　　要：目的:探究脑出血(ICH)在不同时机行微创血肿清除术对患者神经功能以及氧化应激的影响。方法:选取脑出血患者82例,采用随机数字表法分为观察组以及对照组,每组41例,对照组患者在早期(发病6~24 h内)实施微创血肿清除术,观察者患者在超早期(发病6 h内)实施微创血肿清除术,两组患者均持续随访观察6个月。比较两组术后6个月的临床疗效、治疗前后氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]、术后24、72 h血肿清除率、治疗前后的神经功能量表评分(NIHSS)和神经功能缺损评分(CSS)、治疗前后日常生活能力量表(ADL)评分,以及术后6个月内并发症发生情况。结果:术后6个月,观察组的治疗总有效率(97.56%)明显高于对照组(82.93%)(P<0.05)。两组MDA水平治疗后较治疗前均降低,治疗后的SOD水平较治疗前均上升(均P<0.05)。观察组治疗后的MDA水平较对照组下降明显,治疗后的SOD水平较对照组上升(均P<0.05)。两组NIHSS、CSS评分治疗后较治疗前均降低(均P<0.05)。观察组的NIHSS、CSS评分治疗后较对照组明显降低(均P<0.05)。两组ADL评分治疗后较治疗前均升高,观察组的ADL评分治疗后较对照组明显升高(均P<0.05)。术后6个月,观察组(4.88%,2例/41例)较对照组(19.51%,8例/41例)的并发症发生率明显下降低,两组对比差异有统计学意义(P<0.05)。结论:ICH患者,在超早期(发病6 h内)实施微创血肿清除术与早期实施手术相比,能够降低患者的氧化应激反应,改善神经功能,且安全性良好。Objective:To explore the effects of minimally invasive hematoma removal at different times on neurological function and oxidative stress in patients with intracerebral hemorrhage(ICH).Methods:A total of 82 ICH patients were randomly divided into observation group and control group,with 41 cases in each group.The control group was treated with minimally invasive hematoma removal in the early stage(6 to 24 hours after onset),and the observation group was treated with minimally invasive hematoma removal in the ultra-early stage(within 6 hours after onset).The patients in both groups were followed up for 6 months.The clinical efficacy,oxidative stress indexes[malondialdehyde(MDA),superoxide dismutase(SOD)]before and after treatment,The hematoma clearance rate at 24 hours and 72 hours after operation,scores of NIHSS,CSS and ADL before and after treatment,complications within 6 months after operation were compared.Results:Six months after operation,the total effective rate of treatment in the observation group(97.56%)was significantly higher than that(82.93%)in the control group(P<0.05).After treatment,the MDA level of the two groups was lower than that before treatment,and the SOD level after treatment was higher than that before treatment(all P<0.05).After treatment,the MDA level in the observation group was significantly lower than that in the control group,and the SOD level after treatment was higher than that in the control group(all P<0.05).The NIHSS and CSS scores of the two groups after treatment were lower than those before treatment(all P<0.05).The NIHSS and CSS scores of the observation group were significantly lower than those of the control group after treatment(all P<0.05).The ADL score of the two groups after treatment was lower than that before treatment,and the ADL score of the observation group after treatment was significantly lower than that of the control group(all P<0.05).Six months after operation,the incidence of complications in the observation group(4.88%,2 cases/41 cases)was significantly low

关 键 词：脑出血 微创血肿清除术 氧化应激 超早期 血肿清除率 神经功能 

分 类 号：R743.34[医药卫生—神经病学与精神病学]