急诊微创穿刺引流术治疗高血压脑出血患者的临床效果  

Clinical Effect of Emergency Minimally Invasive Puncture Drainage Surgery for Hypertensive Intracerebral Hemorrhage

作　　者：付绳明 FU Shengming(Department of Neurosurgery,Xintai Xiezhuang Hospital of Shandong Yiyang Health Group,Tai'an 271000,China)

机构地区：[1]山东颐养健康集团新泰协庄医院神经外科,山东泰安271000

出　　处：《中国伤残医学》2025年第5期22-25,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:分析急诊微创穿刺引流术治疗高血压脑出血(HICH)患者的效果。方法:回顾性分析2019年6月—2023年8月山东颐养健康集团新泰协庄医院收治的50例HICH患者的临床资料,按手术方法的不同将其分为对照组及研究组,各25例。对照组行开颅血肿清除术,研究组行急诊微创穿刺引流术。对比两组临床疗效、手术相关指标、神经功能、脑血流参数及并发症发生情况。结果:研究组的治疗总有效率为92.00%,高于对照组的68.00%,差异有统计学意义(P<0.05)。研究组的术中出血量为(121.56±13.59)mL,少于对照组的(175.89±18.63)mL,手术时间、术后首次下床活动时间、住院时间分别为(58.71±4.67)min、(6.48±1.23)d、(14.21±2.05)d,均短于对照组的(71.56±6.53)min、(8.71±1.89)d、(18.35±2.69)d,差异均有统计学意义(P<0.05)。术后2周,研究组的神经肽Y、神经元特异性烯醇化酶水平分别为(121.54±11.59)ng/L、(11.24±1.35)mg/L,均低于对照组的(170.63±15.33)ng/L、(14.35±1.87)mg/L,脑源性神经营养因子水平为(6.89±1.44)ng/mL,高于对照组的(5.41±0.69)ng/mL,差异均有统计学意义(P<0.05)。术后2周,研究组的搏动指数为(0.71±0.15),低于对照组的(0.89±0.26),平均血流速度为(68.67±8.31)cm/s,快于对照组的(62.59±6.20)cm/s,差异均有统计学意义(P<0.05)。研究组的并发症发生率为8.00%,与对照组的20.00%比较,差异无统计学意义(P>0.05)。结论:急诊微创穿刺引流术具有创伤小、时间短等优势,可保护HICH患者的神经功能,改善其脑血流参数,且并发症少,具有临床应用价值。Objective:To analyze the effect of emergency minimally invasive puncture drainage surgery in the treatment of hypertensive intracerebral hemorrhage(HICH).Methods:The clinical data of 50 patients with HICH admitted to Xintai Xiezhuang Hospital of Shandong Yiyang Health Group from June 2019 to August 2023 were retrospectively analyzed,and they were divided into a control group and a study group according to different surgical methods with 25 cases.The control group were underwent craniotomy hematoma removal and the study group were underwent emergency minimally invasive puncture drainage surgery.The clinical efficacy,operation related indexes,nerve function,cerebral blood flow parameters and the occurrence of complications were compared between the two groups.Results:The total effective rate of the study group was 92.00%,which was higher than 68.00%of the control group,and the difference was statistically significant(P<0.05).The amount of intraoperative blood loss in the study group was(121.56±13.59)mL,which was less than(175.89±18.63)mL in the control group,the operation time,the first time to get out of bed after operation and hospitalization time were(58.71±4.67)min,(6.48±1.23)d and(14.21±2.05)d,respectively,which were shorter than(71.56±6.53)min,(8.71±1.89)d and(18.35±2.69)d in the control group,and the differences were statistically significant(P<0.05).After operation two weeks,the levels of neuropeptide Y and neuron-specific enolase in the study group were(121.54±11.59)ng/L and(11.24±1.35)mg/L,respectively,which were lower than(170.63±15.33)ng/L and(14.35±1.87)mg/L in the control group,the level of brain-derived neurotrophic factor was(6.89±1.44)ng/mL,higher than(5.41±0.69)ng/mL of control group,and the differences were statistically significant(P<0.05).After operation two weeks,the pulse index of the study group was(0.71±0.15),which was lower than(0.89±0.26)of the control group,and the average blood flow velocity was(68.67±8.31)cm/s,which was faster than(62.59±6.20)cm/s of the control group

关 键 词：高血压脑出血 急诊微创穿刺引流术 神经功能 并发症 

分 类 号：R651.1[医药卫生—外科学]