微创血肿碎吸术治疗颅脑损伤的效果观察  

Effect of minimally invasive hematoma crushing aspiration on patients with craniocerebral injury

作　　者：郑朋飞 孙勇[2] 张宾 ZHENG Pengfei;SUN Yong;ZHANG Bin(Zhengzhou Yangcheng Hospital,Dengfeng 452470,Henan;Henan Provincial People's Hospital,Zhengzhou 450000,Henan)

机构地区：[1]郑州阳城医院,河南登封452470 [2]河南省人民医院,河南郑州450000

出　　处：《菏泽医学专科学校学报》2024年第4期1-4,共4页Journal of Heze Medical College

摘　　要：目的 探究微创血肿碎吸术在颅脑损伤患者治疗中的应用价值。方法 选择我院收治的颅脑损伤患者80例,根据手术方案分为观察组和对照组。观察组38例行微创血肿碎吸术,对照组42例行开颅骨窗血肿清除术。比较两组围手术期指标、血肿清除效果、手术前后血清炎性因子[C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)]水平、血流动力学指标[大脑中动脉收缩末期峰值流速(Vp)、平均血流速度(Vm)、双侧颈内动脉搏动指数(PI)]、神经功能损伤程度(NFD评分)、预后情况(GOS分)及并发症情况。结果 观察组手术时间、术中失血量、脑脊液恢复时间、住院天数均少于对照组(P<0.05);两组术后7 d血肿清除率比较,P>0.05。术后3 d、7 d观察组血清CRP、PCT、IL-6水平均低于对照组(P<0.05);Vp、Vm高于对照组,PI低于对照组(P<0.05)。术后1个月、3个月观察组NFD评分低于对照组,GOS评分高于对照组(P<0.05);两组并发症发生率比较,P>0.05。结论 微创血肿碎吸术治疗颅脑损伤患者,可减轻围术期炎性反应,促进术后早期恢复,改善神经功能及预后,具有较高的安全性。Objective To explore the application value of minimally invasive hematoma crushing aspiration in the treatment of patients with craniocerebral injury.Methods 80 patients with craniocerebral injury in our hospital were collected and divided into minimally invasive group(n=38)and control group(n=42)according to the surgical plan.The minimally invasive group underwent minimally invasive hematoma crushing aspiration,and the control group underwent craniotomy hematoma removal.The perioperative indexes,hematoma clearance effect,serum inflammatory factors[C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6)]levels before and after operation,hemodynamic indexes[peak flow velocity(Vp),mean blood flow velocity(Vm),bilateral internal carotid artery pulse index(PI)],neurological injury degree(NFD score),prognosis(GOS score)and complications were compared between the two groups.Results The operative time,intraoperative blood loss,cerebrospinal fluid recovery time and hospitalization days in the minimally invasive group were less than those in the control group(P<0.05).The comparison of hematoma clearance rate between the two groups 7 d after surgery was with P>0.05.3 and 7 days after surgery,the levels of serum CRP,PCT and IL-6 in minimally invasive group were lower than those in control group(P<0.05);Vp and Vm were higher than those in the control group,and PI was lower than that in the control group(P<0.05).1 month and 3 months after surgery,NFD score in minimally invasive group was lower than that in control group,GOS score was higher than that in control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Minimally invasive hematoma crushing aspiration can optimize operation,reduce perioperative inflammatory response,promote postoperative recovery,improve neurological function and prognosis and has high safety in patients with craniocerebral injury.

关 键 词：颅脑损伤 微创 血肿碎吸术 疗效 

分 类 号：R651.15[医药卫生—外科学]