智能手机简化增强现实定位穿刺联合神经生长因子精准给药技术对高血压幕上脑出血患者病情转归影响研究  

Study on the effect of smart phone simplified augmented reality positioning puncture combined with nerve growth factor precision drug delivery technology on the outcome of hypertensive supratentorial cerebral hemorrhage patients

作　　者：米景良 吴再辉 韩剑 郑冀 Mi Jingliang;Wu Zaihui;Han Jian;Zheng Ji(Department of Neurosurgery,Tangshan Hongci Hospital,Tangshan 063000,China)

机构地区：[1]唐山弘慈医院神经外科,唐山063000

出　　处：《中国医师进修杂志》2024年第8期732-737,共6页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨智能手机简化增强现实(AR)定位穿刺+神经生长因子(NGF)精准给药技术对高血压幕上脑出血(SHICH)患者病情转归的影响。方法回顾性选取2020年2月至2023年1月唐山弘慈医院收治的86例SHICH患者为研究对象,根据治疗方法不同分为穿刺组、穿刺+NGF组,各43例。两组均由同一组医师行智能手机简化AR定位穿刺微创血肿清除术,穿刺+NGF组在此基础上加用30μg NGF经鼻腔给药治疗,1次/d,连续治疗2周。比较两组疗效,比较两组治疗前后脑水肿体积、美国国立卫生研究院卒中量表(NIHSS)评分、血肿量、改良Barthel指数(MBI)评分、S100B蛋白(S100B)、神经元特异性烯醇化酶(NSE)、基质金属蛋白酶-9(MMP-9)、髓鞘碱性蛋白(MBP)、水通道蛋白(AQP)-1、AQP-4、高迁移率族蛋白B1(HMGB1)及C反应蛋白(CRP)水平,比较两组治疗后格拉斯哥预后量表(GOS)评分及并发症发生情况。结果穿刺+NGF组治疗后总有效率高于穿刺组[95.35%(41/43)比81.40%(35/43)],差异有统计学意义(χ^(2)=4.07,P<0.05)。穿刺+NGF组治疗后3、7 d脑水肿体积、血肿量、NIHSS评分低于穿刺组,MBI评分高于穿刺组,差异有统计学意义(P<0.05)。穿刺+NGF组治疗后3、7 d MMP-9、S100B、MBP、NSE水平低于穿刺组,差异有统计学意义(P<0.05)。穿刺+NGF组治疗后3、7 d AQP-1、AQP-4、HMGB1、CRP水平低于穿刺组,差异有统计学意义(P<0.05)。两组治疗后并发症发生率比较差异无统计学意义(P>0.05)。两组治疗后GOS评分比较差异有统计学意义(P<0.05)。结论智能手机简化AR定位穿刺+NGF精准给药技术可改善SHICH患者病情转归,改善神经功能缺损,提升日常活动能力。Objective:To study the effect of smart phone simplified augmented reality(AR)positioning puncture combined with nerve growth factor(NGF)precision drug delivery technology on the outcome of hypertensive supratentorial cerebral hemorrhage(SHICH)patients.Methods:A retrospective study was performed on 86 patients with SHICH admitted to Tangshan Hongci Hospital from February 2020 to January 2023.According to different treatment strategies,they were divided into puncture group and puncture+NGF group,each group with 43 cases.In both groups,the same group of doctors performed minimally invasive hematoma removal by smart phone simplified AR positioning puncture.The puncture+NGF group was additionally treated with NGF 30μg through the nasal cavity once a day for 2 weeks.After treatment,the therapeutic effect was compared between the two groups;the cerebral edema volume,National Institutes of Health Stroke Scale(NIHSS)score,hematoma volume,Modified Barthel Index(MBI)score,S100B protein(S100B),neuron-specific enolase(NSE),matrix metalloproteinase-9(MMP-9),myelin basic protein(MBP),aquaporin(AQP)-1,AQP-4,high mobility group protein B1(HMGB1),C-reactive protein(CRP)before and after treatment were compared between the two groups;the Glasgow Outcome Scale(GOS)score and complications were compared between two groups.Results:The total effective rate in the puncture+NGF group was higher than that in the puncture group:95.35%(41/43)vs.81.40%(35/43),there was statistical difference(χ^(2)=4.07,P<0.05).After treatment for 3 d and 7 d,the brain edema volume,hematoma volume,NIHSS score in the puncture+NGF group were lower than those in the puncture group,while the MBI score was higher than that in the puncture group,there were statistical differences(P<0.05).After treatment for 3 d and 7 d,the MMP-9,S100B,MBP,NSE,AQP-1,AQP-4,HMGB1 and CRP in the puncture+NGF group were lower than those in the puncture group,there were statistical differences(P<0.05).After treatment,the complication rate between the two groups had no statistical differe

关 键 词：脑出血 立体定位技术 神经生长因子 预后 

分 类 号：R651.1[医药卫生—外科学]