经脑沟裂间隙入路对基底核区高血压脑出血患者脑血流、神经功能及微炎症的影响  

Effect of trans sulcus fissure approach on cerebral blood flow,neurological function and microinflammation in patients with hypertensive intracerebral hemorrhage in basal ganglia

作　　者：朱深海[1] 何少武[1] 李霞[1] 吴钟其 ZHU Shenhai;HE Shaowu;LI Xia;WU Zhongqi(Department of Neurosurgery,Wanning People’s Hospital,Wanning 571500,Hainan,China;Department of Neurosurgery,Hainan Western Central Hospital,Danzhou 571700,Hainan,China)

机构地区：[1]万宁市人民医院神经外科,海南万宁571500 [2]海南西部中心医院神经外科,海南儋州571700

出　　处：《中南医学科学杂志》2024年第2期243-246,共4页Medical Science Journal of Central South China

基　　金：海南省卫生健康行业科研项目(20 A200016)。

摘　　要：目的分析经脑沟裂间隙入路对基底核区高血压脑出血患者脑血流、神经功能及微炎症的影响。方法选择基底核区高血压脑出血患者96例,按手术方式不同分为观察组(n=47,经脑沟裂间隙入路)和对照组(n=49,常规经脑回皮质手术)。比较两组患者脑血流动力学[外周阻力(Rv)、平均血流量(Qm)、平均血流速度(Vm)]、神经功能缺损评分(NHISS)、血清神经因子[神经生长因子(NGF)、神经元特异性烯醇化酶(NSE)、神经肽(NPY)]、炎症因子[超敏C反应蛋白(hs-CRP)、金属基质蛋白酶-9(MMP-9)、肿瘤坏死因子-α(TNF-α)]水平以及并发症情况。结果观察组术后出血量、意识恢复时长、住院时长低于对照组(P<0.05)。术后两组Rv均降低,Qm、Vm均升高,血清NSE、NGF、NPY、MMP-9、hs-CRP、TNF-α水平及NHISS评分均下降,且观察组较对照组更为显著(P<0.05)。观察组气管切开、脑再出血并发症发生率低于对照组(P<0.05)。结论经脑沟裂间隙入路手术能有效改善基底核区高血压脑出血患者临床疗效和脑血流,减轻微炎症状态,促进神经功能恢复。Aim To investigate the effect of trans sulcus fissure approach on cerebral blood flow,neurological function and microinflammation in patients with hypertensive intracerebral hemorrhage in basal ganglia region.Methods 96 patients with hypertensive intracerebral hemorrhage in basal ganglia region were selected and divided into observation group(n=47,via sulcus space approach)and control group(n=49,conventional via gyrocortical surgery)according to different operation methods.Cerebral hemodynamics(vascular resistance(Rv),quality manage(Qm),mean velocity(Vm)),neurological deficit score(NHISS),serum nerve factors(nerve growth factor(NGF),neuron specific enolase(NSE),neuropeptide(NPY)),inflammatory factors(high-sensitivity C-reactive protein(hs-CRP),matrix metalloproteinase-9(MMP-9),tumor necrosis factor-α(TNF-α))were compared between the two groups.Results The postoperative blood loss,consciousness recovery time and hospitalization time of the observation group were lower than those of the control group(P<0.05).After operation,Rv decreased,whereas Qm and Vm increased.The levels of serum NSE,NGF,NPY,MMP-9,hs-CRP,TNF-α,and NHISS scores decreased in both groups,and the decrease was more significant in the observation group than in the control group(P<0.05).The incidence of complications of tracheotomy and cerebral rebleeding in the observation group was lower than that in the control group(P<0.05).Conclusion The operation by the sulcus fissure approach can effectively improve the clinical efficacy and cerebral blood flow of patients with hypertensive intracerebral hemorrhage in the basal ganglia,reduce the micro inflammatory state,and promote the recovery of neural function.

关 键 词：经脑沟裂间隙入路 基底核区高血压脑出血 脑血流动力学 神经功能 微炎症 

分 类 号：R743[医药卫生—神经病学与精神病学]