微创术治疗自发性脑出血灶周水肿的效果  

Therapeutic Effect of Minimally Invasive Surgery on Perifocal Edema of Spontaneous Cerebral Hemorrhage

作　　者：齐俊青 申法政[1] 吕爱华[1] QI Junqing;SHEN Fazheng;L Aihua(Neurosurgery Department,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453000,China)

机构地区：[1]新乡医学院第一附属医院神经外科,河南新乡453000

出　　处：《河南医学研究》2024年第14期2539-2542,共4页Henan Medical Research

摘　　要：目的探讨微创术治疗自发性脑出血灶周水肿的疗效及对脑水肿指数、脑脊液水平的影响,以期为临床优化治疗方案提供理论依据。方法采用前瞻性随机对照研究,选取2020年6月至2022年6月收治的78例自发性脑出血合并出血灶周水肿患者作为研究对象,采用随机数字表、密封信法分为观察组(39例)与对照组(39例),对照组接受开颅大骨瓣减压术治疗,观察组接受立体定向手术抽吸治疗。观察两组患者术后3个月的手术疗效,记录两组围手术期指标(手术、住院时间),比较两组术前、术后14 d的脑水肿指数、脑脊液水平[白细胞介素-1β(IL-1β)、S-100钙结合蛋白β(S-100β)]以及术后并发症发生情况。结果术后3个月,观察组临床疗效优于对照组,差异有统计学意义(P<0.05)。观察组手术、住院时间短于对照组,差异有统计学意义(P<0.05)。术后5 d,两组患者脑水肿指数均下降,且观察组小于对照组,差异有统计学意义(P<0.05)。术后14 d,两组患者脑脊液IL-1β、S-100β水平均下降,且观察组低于对照组,差异有统计学意义(P<0.05)。两组患者术后均出现并发症,但差异无统计学意义(P>0.05)。结论微创术能够有效治疗自发性脑出血灶周水肿,改善脑水肿程度,减轻脑损伤程度,值得临床推广应用。Objective To explore the therapeutic effect of minimally invasive surgery on perifocal edema of spontaneous cerebral hemorrhage and its impact on brain edema index and cerebrospinal fluid level,in order to provide theoretical basis for optimizing treatment plans in clinical practice.Methods A prospective randomized controlled study was conducted,selecting 78 patients with spontaneous cerebral hemorrhage combined with edema around the bleeding site from June 2020 to June 2022 as the study subjects.The study group was divided into an observation group(39 cases)and a control group(39 cases)using a random number table and sealed letter method.The control group received craniotomy and large bone flap decompression surgery,while the observation group received stereotactic surgical aspiration treatment.The surgical efficacy of the two groups was observed 3 months after operation.The perioperative indexes(operation and hospitalization time)of the two groups were recorded.The cerebral edema index,cerebrospinal fluid level[interleukin-1β(IL-1β),S-100 calcium binding proteinβ(S-100β)]and postoperative complications were compared between the two groups before and 14 days after operation.Results Three months after surgery,the clinical efficacy of the observation group was better than that of the control group,with a statistical significant difference(P<0.05).The observation group had shorter surgical and hospital stays compared to the control group,with a statistical significant difference(P<0.05).On the 5th day after surgery,the brain edema index of both groups of patients decreased,and the observation group was smaller than the control group,with a statistical significant difference(P<0.05).The levels of IL-1βand S-100βin the cerebrospinal fluid of both groups of patients decreased,and the observation group was lower than the control group 14 days after surgery,with a statistical significant difference(P<0.05).Both groups of patients experienced postoperative complications,but there was no statistical significant diff

关 键 词：自发性脑出血 水肿 立体定向手术 开颅大骨瓣减压术 

分 类 号：R743[医药卫生—神经病学与精神病学]