小骨窗开颅术治疗高血压脑出血的临床效果研究  

A study on the clinical effect of small bone window craniotomy in the treatment of hypertensive intercerebral hemorrhage

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作  者:门东海 尹延庆 吴伟川 黄梓雄 MEN Dong-hai;YIN Yan-qing;WU Wei-chuan(Affiliated Hospital of Guangdong Medical University,Zhanjiang 524000,China)

机构地区:[1]广东医科大学附属医院,524000

出  处:《中国现代药物应用》2024年第21期6-10,共5页Chinese Journal of Modern Drug Application

摘  要:目的探究临床治疗高血压脑出血(HICH)患者,予以小骨窗开颅术治疗的效果。方法选取70例HICH患者,采用计算机随机数字表法分为对照组和研究组,每组35例。对照组采取常规治疗,研究组采取小骨窗开颅术治疗。对比两组患者美国国立卫生研究院卒中量表(NIHSS)评分、手术指标(手术时间、术中出血量、意识恢复时间、住院时间)、相关指标[血清S100B蛋白、神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)]、治疗效果、并发症发生情况。结果治疗后15、30 d,研究组NIHSS评分分别为(11.83±2.62)、(6.42±1.11)分,均低于对照组的(16.87±1.86)、(10.68±1.09)分,差异有统计学意义(P<0.05)。研究组患者手术时间(1.52±0.42)h、意识恢复时间(1.65±0.52)d、住院时间(15.52±3.22)d短于对照组的(2.45±0.38)h、(4.52±0.39)d、(25.86±2.68)d,术中出血量(72.54±5.42)ml少于对照组的(157.52±5.86)ml,差异有统计学意义(P<0.05)。治疗后,研究组S100B蛋白(0.54±0.12)μg/L、NSE(10.25±2.14)ng/ml低于对照组的(0.87±±0.17)μg/L、(15.86±2.21)ng/ml,BDNF(7.17±1.05)μg/L高于对照组的(5.48±0.68)μg/L,差异有统计学意义(P<0.05)。研究组治疗总有效率(94.29%)高于对照组(74.29%),差异有统计学意义(χ^(2)=5.2851,P<0.05)。研究组并发症发生率(5.71%)低于对照组(31.43%),差异有统计学意义(χ^(2)=7.6518,P<0.05)。结论临床使用小骨窗开颅术治疗HICH患者效果显著,能减少并发症发生风险,减轻神经功能损伤,改善患者血清水平,值得临床推广使用。Objective To explore the effect of small bone window craniotomy in the treatment of hypertensive intercerebral hemorrhage(HICH).Methods 70 patients with HICH were selected and divided into a control group and a study group by computer random number table method,with 35 cases in each group.The control group was given conventional treatment,and the study group was given small bone window craniotomy.Patients in both groups were compared in terms of National Institutes of Health Stroke Scale(NIHSS)score,surgical indicators(operation time,intraoperative blood loss,consciousness recovery time,and hospitalization time),related indicators[serum S100B protein,neuron-specific enolase(NSE),brain-derived neurotrophic factor(BDNF)],therapeutic effect,and complications.Results After 15 and 30 d of treatment,NIHSS scores of the study group were(11.83±2.62)and(6.42±1.11)points,which were lower than(16.87±1.86)and(10.68±1.09)points of the control group,and the difference was statistically significant(P<0.05).In the study group,the operation time was(1.52±0.42)h,the consciousness recovery time was(1.65±0.52)d,and the hospitalization time was(15.52±3.22)d,which were shorter than(2.45±0.38)h,(4.52±0.39)d,and(25.86±2.68)d in the control group;the intraoperative blood loss of(72.54±5.42)ml in the study group was lower than(157.52±5.86)ml in the control group;the difference was statistically significant(P<0.05).After treatment,the study group had S100B protein of(0.54±0.12)μg/L and NSE of(10.25±2.14)ng/ml,which were lower than(0.87±±0.17)μg/L and(15.86±2.21)ng/ml in the control group;BDNF of(7.17±1.05)μg/L in the study group was higher than(5.48±0.68)μg/L in the control group;the difference was statistically significant(P<0.05).The total effective rate of the study group(94.29%)was higher than that of the control group(74.29%),and the difference was statistically significant(χ^(2)=5.2851,P<0.05).The complication rate of the study group(5.71%)was lower than that of the control group(31.43%),and the difference was

关 键 词:高血压脑出血 小骨窗开颅术 神经功能损伤 治疗效果 

分 类 号:R651.12[医药卫生—外科学] R544.1[医药卫生—临床医学]

 

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