立体定向手术治疗重型脑干出血临床疗效分析  

Analysis of Clinical Effect of Stereotactic Surgery on Severe Brain Stem Hemorrhage

作　　者：李建东 高上 刘永生[1] 李想[1] 孙向 杨震 郭士琨[1] LI Jian-dong;GAO Shang;LIU Yong-sheng;LI Xiang;SUN Xiang;YANG Zhen;GUO Shi-kun(Department of Neurosurgery,Shangqiu First People's Hospital,Shangqiu 476100,Henan Province,China)

机构地区：[1]商丘市第一人民医院神经外科,河南商丘476100

出　　处：《罕少疾病杂志》2025年第1期35-37,共3页Journal of Rare and Uncommon Diseases

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20191493)。

摘　　要：目的 探讨立体定向手术治疗重型脑干出血临床疗效分析。方法 对收治的80例重型脑干出血患者治疗情况进行回顾性分析,选取时间2021年1月至2022年12月,只愿接受保守治疗患者40例作为对照组,愿意接受立体定向手术治疗患者40例作为研究组,比较两组治疗7d时GCS评分情况,比较两组治疗30d时NSE、IL-6水平情况,比较两组治疗90d时mRs评分情况,比较两组患者家属心理情绪情况。结果 治疗7d时,研究组GCS评分9-15分的百分比高于对照组,死亡百分比低于对照组(P<0.05);与治疗前比较,治疗30d时两组NSE水平、IL-6水平均有所下降(P<0.05),与对照组比较,治疗30d时研究组NSE水平、IL-6水平均更低(P<0.05);治疗90d时,研究组mRs评分在0-2级者百分比高于对照组,死亡百分比低于对照组(P<0.05);治疗后两组患者家属心理不良情绪均有所减轻(P<0.05),与对照组比较,研究组治疗90d时的SDS、SAS评分均更低(P<0.05)。结论 重型脑干出血患者治疗中采用立体定向手术治疗,相较于常规保守治疗,患者机体炎症反应缓解幅度更大,患者死亡率显著降低,疾病预后有明显改善,且能够有效减轻患者家属的心理负担、心理压力,值得积极应用,临床疗效更为优良。Objective To explore the clinical effect of stereotactic surgery in the treatment of severe brain stem hemorrhage.Methods A retrospective analysis was conducted on the treatment of 80 patients with severe brain stem hemorrhage.40 patients who were willing to receive conservative treatment were selected as the control group and 40 patients who were willing to receive stereotactic surgery were selected as the study group from January 2021 to December 2022.The GCS scores of the two groups were compared after 7 days of treatment.NSE and IL-6 levels were compared between the two groups at 30 days of treatment,mRs Scores were compared between the two groups at 90 days of treatment,and psychological and emotional conditions of patients'family members were compared between the two groups.Results After 7 days of treatment,the percentage of GCS score 9-15 in study group was higher than that in control group,and the percentage of death was lower than that in control group(P<0.05).Compared with before treatment,NSE level and IL-6 level were decreased in both groups at 30 days of treatment(P<0.05);compared with control group,NSE level and IL-6 level in study group were lower at 30 days of treatment(P<0.05);after 90 days of treatment,the percentage of mRs Scores in the study group was higher than that in the control group,and the percentage of death was lower than that in the control group(P<0.05).After treatment,family members of the patients in both groups were relieved(P<0.05),and the SDS and SAS scores of the study group were lower than those of the control group at 90 days of treatment(P<0.05).Conclusion Compared with conventional conservative treatment,stereotactic surgery in the treatment of patients with severe brain stem hemorrhage can significantly reduce the inflammatory response of patients,significantly reduce the mortality of patients,significantly improve the prognosis of the disease,and effectively reduce the psychological burden and psychological pressure of patients'families,which is worthy of active applicat

关 键 词：重型脑干出血 立体定向手术 炎症反应 不良心理情绪 疾病预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]