摘要
目的:探讨亚低温辅助下微创手术对高血压脑出血患者颅内血肿吸收、神经损伤程度的影响。方法:收集本院收治的高血压脑出血患者90例,回顾入组患者接受的治疗方案、临床检查结果,分为接受微创手术治疗的对照组47例、接受亚低温辅助下微创手术治疗的观察组43例。入院后即刻、治疗1周后,采用头颅CT记录两组患者的颅内血肿容积、经颅多普勒(TCD)检测患侧大脑中动脉血流动力学参数;采用全自动生化仪检测血清神经损伤指标含量,采用硫代巴比妥酸法检测氧化/抗氧化因子含量,采用酶联免疫吸附法(ELISA)检测炎症因子含量。结果:治疗前,两组颅内血肿容积、患侧大脑中动脉血流动力学参数以及血清神经损伤指标、氧化/抗氧化因子、炎症因子含量的差异无统计学意义(P>0.05)。治疗后1周,观察组颅内血肿容积小于对照组,患侧大脑中动脉血流动力学参数Vs、Vm、rCBF水平高于对照组,TTP水平低于对照组,血清中IGF-1、SDF-1、T-AOC、SOD含量高于对照组,血清中YKL-40、MDA、CRP、IL-1、IL-8、TNF-α含量低于对照组(P<0.05)。结论:亚低温辅助下微创手术可促进高血压脑出血患者颅内血肿吸收,减轻神经损伤程度。
Objective：To study the effect of mild hypothermia-assisted minimally invasive surgery on the intracranial hematoma absorption and the degree of nerve injury in patients with hypertensive cerebral hemorrhage.Methods：A total of 90 patients with hypertensive cerebral hemorrhage who were treated in our hospital between April 2013 and February 2016 were collected and divided into control group（n=47）who received minimally invasive surgery and observation group（n=43）who received mild hypothermia-assisted minimally invasive surgery after the therapy that patients received and the clinical findings were reviewed.Immediately after admission and 1week after treatment,head CT was used to record the intracranial hematoma volume of both groups,and the transcranial Doppler（TCD）was used to detect the middle cerebral arterial hemodynamic parameters;automatic biochemical analyzer was used to detect serum contents of nerve injury indexes,thiobarbituric acid method was used to detect the contents of oxidation/anti-oxidation factors,and the enzyme-linked immunosorbent assay（ELISA）was used to determine the contents of inflammatory cytokines.Results：Before treatment,the differences in intracranial hematoma volume and affected-side middle cerebral arterial hemodynamic parameters as well as serum contents of nerve injury indexes,oxidation/antioxidation factors and inflammatory cytokines were not statistically significant between two groups of patients（P〉0.05）.One week after treatment,the intracranial hematoma volume of observation group was less than that of control group,the affected-side middle cerebral arterial hemodynamic parameters Vs,Vm and rCBF levels were higher than those of control group while the TTP level was lower than that of control group,and serum IGF-1,SDF-1,T-AOC and SOD contents were higher than those of control group while serum YKL-40,MDA,CRP,IL-1,IL-8and TNF-αcontents were lower than those of control group（P〈0.05）.Conclusion：Mild hypothermia-assisted minimally invasive surgery can promote the intracranial hematoma absorption and reduce the degree of nerve injury in patients with hypertensive cerebral hemorrhage.
出处
《海南医学院学报》
CAS
2017年第7期950-953,957,共5页
Journal of Hainan Medical University
基金
四川省卫生厅科研项目(140249)~~
关键词
高血压脑出血
微创手术
亚低温
颅内血肿吸收
神经损伤
Hypertensive cerebral hemorrhage
Minimally invasive surgery
Mild hypothermia
Intracranial hematoma absorption
Nerve injury
作者简介
罗飞（1982-），男，四川自贡人，硕士，主治医师，电话：0813—2304465、13629020930，Email：1795282915@qq．com。
