小骨窗和穿刺手术对基底节区高血压中量脑出血患者炎性细胞、凝血指标及MRS评分的影响  

Effects of small bone window and puncture surgery on inflammatory cells,coagulation indexes,and MRS scores in patients with moderate intracerebral hemorrhage in basal ganglia hypertension

作　　者：王鹏 王晓澍[1] 向斌[2] 曹明川[1] 徐睿 霍钢[1] WANG Peng;WANG Xiaoshu;XIANG Bin;CAO Mingchuan;XU Rui;HUO Gang(Department of Neurosurgery,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Neurosurgery,Chongqing University Qianjiang Hospital,Chongqing 409000,China)

机构地区：[1]重庆医科大学附属第一医院神经外科,重庆400016 [2]重庆大学附属黔江医院神经外科,重庆409000

出　　处：《重庆医学》2023年第17期2610-2614,共5页Chongqing medicine

基　　金：重庆市黔江区科技计划项目(黔科计2022056)。

摘　　要：目的研究小骨窗和血肿穿刺手术对基底节区高血压中量脑出血患者外周血炎性细胞、血小板、凝血指标及改良Rankin量表(MRS)评分的影响。方法回顾性分析2017年6月至2021年3月于重庆医科大学附属第一医院神经外科行手术治疗的患者资料。根据手术方式的不同,将受试者分为穿刺组(53例)、小骨窗组(51例),比较术前、术后相关指标及患者出院时的神经功能情况。结果两组患者术前一般资料无明显差异。术后小骨窗组纤维蛋白原明显高于穿刺组,血小板数低于穿刺组,差异有统计学意义(P<0.05)。与术前比较,术后小骨窗组白细胞计数、中性粒细胞计数、纤维蛋白原升高,血小板明显降低,差异有统计学意义(P<0.05);术后穿刺组凝血酶时间降低,纤维蛋白原升高,差异有统计学意义(P<0.05)。与穿刺组比较,小骨窗组手术时间更长、出院时MRS评分更高(P<0.05)。结论同等情况下,穿刺对基底节区高血压中量脑出血患者炎性细胞及凝血酶影响更小、手术时间更短、神经功能恢复更好。Objective To explore the effects of small bone window and hematoma puncture surgery on peripheral blood inflammatory cells,platelets,coagulation indexes,and modified Rankin scale(MRS)in patients with moderate intracerebral hemorrhage in basal ganglia hypertension.Methods The data of patients who underwent surgical treatment in the Department of Neurosurgery,the First Affiliated Hospital of Chongqing Medical University from June 2017 to March 2021 were retrospectively analyzed.According to the different surgical methods,the subjects were divided into the puncture group(53 cases)and the small bone window group(51 cases),and the related indexes before and after surgery and the neurological function at discharge were compared.Results There was no significant difference in general data between the two groups before surgery.Fibrinogen in the small bone window group was significantly higher than that in the puncture group,and the number of platelets was lower than that in the puncture group,with statistical significance(P<0.05).Compared with before surgery,the white blood cell count,neutrophil count and fibrinogen in the small bone window group increased after operation,and the platelet decreased significantly(P<0.05).The thrombin time decreased and fibrinogen increased in the puncture group after surgery,and the difference was statistically significant(P<0.05).Compared with the puncture group,the small bone window group had longer operation time and higher MRS score at discharge(P<0.05).Conclusion Under the same circumstances,puncture has less effect on inflammatory cells and thrombin in patients with moderate intracerebral hemorrhage in basal ganglia hypertension,shorter operation time,better recovery of nerve function.

关 键 词：高血压脑出血 穿刺引流 小骨窗开颅 改良Rankin量表 

分 类 号：R722[医药卫生—儿科]