显微镜下经侧裂入路与颞中回造瘘入路血肿清除术治疗脑出血的临床效果  

Clinical Effect of Microscopic Trans-lateral Fissure Approach and the Middle Temporal Gyrus Fistula Approach for Hematoma Removal in the Treatment of Cerebral Hemorrhage

作　　者：赖荣福[1] 李育华 梁鄂 LAI Rongfu;LI Yuhua;LIANG E(Jian’ou Municipal Hospital,Jian’ou 353100,China;不详)

机构地区：[1]建瓯市立医院,福建建瓯353100

出　　处：《中外医学研究》2024年第5期1-5,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究显微镜下经侧裂入路与颞中回造瘘入路血肿清除术治疗脑出血的效果。方法:选择2021年1月—2023年1月建瓯市立医院收治86例脑出血患者,应用随机数表法将其分为对照组(颞中回造瘘入路)及观察组(显微镜下经侧裂入路),各43例。比较两组手术时间、出血量、下床活动时间、血肿清除率、炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)、C反应蛋白(CRP)]、神经因子[神经元特异性烯醇化酶(NSE)、神经营养因子(NF)、S100B蛋白、D-二聚体]、应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)、脂质过氧化产物(LPO)、谷胱甘肽过氧化物酶(GSH-Px)]、预后情况。结果:观察组手术时间、出血量、下床活动时间、血肿清除率优于对照组,差异有统计学意义(P<0.05)。术前,两组IL-6、TNF-α、PCT、CRP水平比较,差异无统计学意义(P>0.05);术后,两组IL-6、TNF-α、PCT、CRP水平均升高,但观察组低于对照组,差异有统计学意义(P<0.05)。术前,两组NSE、NF、S100B蛋白、D-二聚体水平比较,差异无统计学意义(P>0.05);术后,两组NSE、NF、S100B蛋白、D-二聚体水平均降低,观察组低于对照组,差异有统计学意义(P<0.05)。术前,两组MDA、SOD、LPO、GSH-Px水平比较,差异无统计学意义(P>0.05);术后,两组MDA、SOD、LPO、GSH-Px水平均升高,但观察组MDA、LPO水平低于对照组,SOD、GSH-Px水平高于对照组,差异有统计学意义(P<0.05)。对照组预后良好率低于观察组,差异有统计学意义(P<0.05);两组死亡率比较,差异无统计学意义(P>0.05)。结论:显微镜下经侧裂入路血肿清除术治疗脑出血,可提升血肿清除率,减轻炎症反应、神经功能损伤,利于患者预后恢复。Objective:To investigate the effect of microscopic trans-lateral fissure approach and middle temporal gyrus fistula approach for hematoma removal in the treatment of cerebral hemorrhage.Method:From January 2021 to January 2023,86 patients with cerebral hemorrhage were selected from Jian’ou Municipal Hospital,the patients were divided into control group(middle temporal gyrus fistula approach)and observation group(microscopic trans-lateral fissure approach),with 43 cases in each group.Operation time,blood loss,time to get out of bed,hematoma clearance rate,inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),procalcitonin(PCT),C-reactive protein(CRP)],neurofactors[neuron-specific enolase(NSE),neurotrophic factor(NF),S100B protein,D-dimer],stress index[malondialdehyde(MDA),superoxide dismutase(SOD),lipid peroxidation product(LPO),glutathione peroxidase(GSH-Px)],prognosis were compared between the two groups.Result:Operation time,blood loss,getting out of bed time and hematoma clearance rate in observation group were better than those in control group,the differences were statistically significant(P<0.05).Before operation,there were no significant differences in IL-6,TNF-α,PCT and CRP levels between the two groups(P>0.05).After operation,the levels of IL-6,TNF-α,PCT and CRP in both groups were increased,but the levels in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Before operation,there were no significant differences in the levels of NSE,NF,S100B protein and D-dimer between the two groups(P>0.05).After operation,the levels of NSE,NF,S100B protein and D-dimer were decreased in both groups,and the levels in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Before operation,there were no significant differences in MDA,SOD,LPO and GSH-Px levels between the two groups(P>0.05).After operation,the levels of MDA,SOD,LPO and GSH-Px were increased in both gr

关 键 词：显微镜下经侧裂入路 颞中回造瘘入路 血肿清除术 脑出血 应激反应 炎症因子 

分 类 号：R651.1[医药卫生—外科学]