摘要
目的分析神经内镜下经额叶入路血肿清除手术对高血压脑出血(HICH)患者的影响.方法选取2021年8月—2023年8月泗水县人民医院收治的92例HICH患者为研究对象,按随机数字表法将其分为对照组与观察组,各46例.对照组行神经内镜下经颞叶入路血肿清除手术,观察组行神经内镜下经额叶入路血肿清除手术.对比两组临床疗效、围术期指标、神经营养因子、脑血流动力学、并发症发生情况.结果观察组治疗总有效率和血肿清除率分别为93.48%、95.65%,均高于对照组的78.26%、80.43%,组间差异有统计学意义(P<0.05);术后,观察组神经生长因子、脑源性神经营养因子、胰岛素样生长因子-1水平分别为(149.87±14.65)pg/mL、(4.89±0.63)ng/mL、(114.83±9.20)μg/L,均高于对照组的(138.64±12.36)pg/mL、(4.31±0.48)ng/mL、(106.95±7.64)μg/L,搏动指数为(0.70±0.11),低于对照组的(0.91±0.17),平均血流速度为(69.85±7.20)cm/s,快于对照组的(63.68±5.19)cm/s,组间差异有统计学意义(P<0.05).两组术中出血量,手术、住院时间与并发症发生率比较,组间差异无统计学意义(P>0.05).结论神经内镜下经额叶入路血肿清除手术可有效清除HICH患者血肿,提高神经营养因子水平,改善脑血流动力学,安全性良好.
Objective To analyze the effect of neuroendoscopic transfrontal approach hematoma evacuation on patients with hypertensive intracerebral hemorrhage(HICH).Methods 92 patients with HICH admitted to the Sishui Contry People's Hospital from August 2021 to August 2023 were selected as the research objects.According to the random number table method,they were divided into a control group and an observation group,with 46 cases in each group.The control group underwent neuroendoscopic hematoma removal via temporal lobe approach,and the observation group underwent neuroendoscopic hematoma removal via frontal lobe approach.The clinical efficacy,perioperative indicators,neurotrophic factors,cerebral hemodynamics,and complications were compared between the two groups.Results The total effective rate and hematoma clearance rate of the observation group were 93.48%and 95.65%,which were higher than 78.26%and 80.43%of the control group,the differences were statistically significant between the two groups(P<0.05).After operation,the levels of nerve growth factor,brain-derived neurotrophic factor,insulin-like growth factor-1 in the observation group were(149.87±14.65)pg/mL,(4.89±0.63)ng/mL and(114.83±9.20)μg/L,respectively,which were higher than(138.64±12.36)pg/mL,(4.31±0.48)ng/mL,(106.95±7.64)μg/L in the control group,and the pulsatility index was(0.70±0.11),which were lower than(0.91±0.17)in the control group,the average blood flow velocity was(69.85±7.20)cm/s in the control group,which was faster than(63.68±5.19)cm/s in the control group,and the differences between the two groups were statistically significant(P<0.05).There was no significant difference in intraoperative blood loss,operation time,hospital stay and incidence of complications between the two groups(P>0.05).Conclusion Endoscopic transfrontal approach hematoma evacuation can effectively remove the hematoma in patients with HICH,improve the levels of neurotrophic factors and cerebral hemodynamics,has good security.
作者
王伟
吴国清
WANG Wei;WU Guoqing(Department of Neurosurgery,Sishui County People's Hospital,Jining Shandong,273200,China;Endoscopy Center,Jining Hospital of Traditional Chinese Medicine,Jining Shandong,272137,China)
出处
《反射疗法与康复医学》
2024年第3期167-169,173,共4页
Reflexology And Rehabilitation Medicine
关键词
高血压脑出血
并发症
血流动力学
Hypertensive intracerebral hemorrhage
Complications
Hemodynamics
