神经内镜辅助去骨瓣血肿清除术治疗高血压脑出血的效果及对患者应激反应和免疫功能的影响  

Effect of neuroendoscopy-assisted bone flap hematoma removal in the treatment of hypertensive cerebral hemorrhage and its influences on stress response and immune function of patients

作　　者：孔德军 苗海军 薛世斌 马兵博 乔楠 吕晨辉 毛彦君 陈伟[2] KONG Dejun;MIAO Haijun;XUE Shibin;MA Bingbo;QIAO Nan;LYU Chenhui;MAO Yanjun;CHEN Wei(Xi'an Fengcheng Hospital,Xi'an 710016;the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安凤城医院,陕西西安710016 [2]西安交通大学第一附属医院,陕西西安710061

出　　处：《临床医学研究与实践》2023年第16期66-69,共4页Clinical Research and Practice

摘　　要：目的探究神经内镜辅助去骨瓣血肿清除术治疗高血压脑出血的效果及对患者应激反应和免疫功能的影响。方法选取2017年3月至2020年8月本院接收的106例高血压脑出血患者作为研究对象,采用随机数字表法将其分为常规组(去骨瓣血肿清除术)和研究组(神经内镜辅助去骨瓣血肿清除术),各53例。比较两组患者的治疗效果。结果术后1周,研究组的美国国立卫生研究院卒中量表(NIHSS)评分低于常规组(P<0.05)。术后24 h,研究组的内皮素(ET)、皮质醇(Cor)水平低于常规组(P<0.05)。术后5 d,两组的白细胞分化抗原3阳性(CD3^(+))、白细胞分化抗原4阳性(CD4^(+))与白细胞分化抗原8阳性(CD8^(+))及CD4^(+)/CD8^(+)均改善,且研究组优于常规组(P<0.05)。研究组的血肿清除率、脑积水缓解率高于常规组,术后并发症总发生率低于常规组(P<0.05)。结论神经内镜辅助去骨瓣血肿清除术治疗高血压脑出血能有效缓解患者应激反应,促进神经功能恢复,提高血肿清除率、脑积水缓解率及免疫功能,改善预后,值得推广。Objective To explore the effect of neuroendoscopy-assisted bone flap hematoma removal in the treatment of hypertensive cerebral hemorrhage and its influences on stress response and immune function of patients.Methods A total of 106 patients with hypertensive cerebral hemorrhage received in our hospital from March 2017 to August 2020 were selected as the research objects.The patients were divided into routine group(bone flap hematoma removal)and study group(neuroendoscopy-assisted bone flap hematoma removal)by random number table method,with 53 cases in each group.The therapeutic effects of the two groups of patients were compared.Results One week after operation,the National Institutes of Health Stroke Scale(NIHSS)score of the study group was lower than that of the routine group(P<0.05).At 24 h after operation,the levels of endothelin(ET)and cortisol(Cor)in the study group were lower than those in the routine group(P<0.05).At 5 d after operation,the cluster of differentiation 3 positive(CD3^(+)),cluster of differentiation 4 positive(CD4^(+)),cluster of differentiation 8 positive(CD8^(+))and CD4^(+)/CD8^(+)in the two groups improved,and those in the study group were better than the routine group(P<0.05).The hematoma clearance rate and hydrocephalus remission rate of the study group were higher than those of the routine group,and the total incidence of postoperative complications was lower than that of the routine group(P<0.05).Conclusion Neuroendoscopy-assisted bone flap hematoma removal in the treatment of hypertensive cerebral hemorrhage can effectively alleviate the stress response of patients,promote the recovery of neurological function,improve the hematoma clearance rate,hydrocephalus remission rate and immune function,and ameliorate the prognosis,which is worth promoting.

关 键 词：高血压脑出血 去骨瓣血肿清除术 神经内镜 应激反应 免疫功能 

分 类 号：R743.34[医药卫生—神经病学与精神病学]