摘要
目的探讨微创颅内血肿抽吸术对高血压脑出血患者B型脑钠肽(BNP)、C-反应蛋白(CRP)、同型半胱氨酸(Hcy)水平和生活质量的影响。方法选取2013年12月至2016年12月确诊治疗的高血压脑出血患者100例,依据随机数表法随机分为微创抽吸组和常规清除组,每组50例。常规清除组患者给予常规开颅骨窗血肿清除术治疗,微创抽吸组患者给予微创颅内血肿抽吸术治疗,采用酶联免疫吸附法(ELISA)检测血浆BNP、CRP、Hcy水平,采用美国国立卫生研究院卒中量表(NIHSS)评估治疗疗效,采用日常生活能力量表(ADL)评估生活质量,随访6个月,统计分析所有患者治疗疗效、术中出血量、手术、住院时间、血肿清除、并发症、死亡情况和治疗前后血浆BNP、CRP、Hcy水平及治疗前、治疗后1、3、6个月的生活质量情况。结果微创抽吸组患者治疗后NIHSS得分明显低于常规清除组,前者治疗显效率明显高于后者,差异有统计学意义(P<0.05);微创抽吸组患者治疗后血浆BNP、CRP、Hcy水平明显低于常规清除组,差异有统计学意义(P<0.05);微创抽吸组患者术中出血量、手术、住院时间明显低于常规清除组,前者血肿清除率明显高于后者,差异有统计学意义(P<0.05);微创抽吸组和常规清除组患者死亡率差异无统计学意义(P>0.05),但前者并发症发生率明显低于后者,差异有统计学意义(P<0.05);微创抽吸组患者治疗后1、3、6个月的ADL得分明显高于常规清除组,差异有统计学意义(P<0.05)。结论微创颅内血肿抽吸术治疗可有效改善高血压脑出血患者的神经功能和血肿清除效果,可有效减少患者的术中创伤,有利于患者术后身体康复和生存,其机制可能与BNP、CRP、Hcy水平变化有关,有利于减少患者并发症的发生及促进其生活质量的恢复,值得临床作进一步推广。
Objective To investigate the influence of minimally invasive intracranial hematoma suction surgery on the levels of B type brain natriuretic peptide（ BNP）,C reactive protein（ CRP）,homocysteine（ Hcy） and the quality of life of patients with hypertensive cerebral hemorrhage. Methods One hundred patients with hypertensive cerebral hemorrhage who were definitely diagnosed and treated in our hospital from December 2012 to December 2016 were enrolled in the study.According to random number table,these patients were divided into minimally invasive suction therapy group and conventional clearance therapy group,with 50 patients in each group. The patients in conventional clearance therapy group were treated by conventional open cranial window to remove haematoma,however,the patients in minimally invasive suction therapy group were treated by minimally invasive intracranial hematoma suction surgery. The enzyme-linked immunosorbent assay（ ELISA）was used to detect plasma levels of BNP,CRP and Hcy. The National Institutes of Health Stroke Scale（ NIHSS） scores were used to evaluate the therapeutic effects,and the daily life ability scale（ ADL） was used to assess the quality of life of patients,and these patients were followed up for 6 months. The therapeutic effects,intraoperative bleeding volume,operation time,the duration of hospitalization,hematoma removal status,complications,death rate,the plasma levels of BNP,CRP,Hcy before and after treatment,and life quality of patients before and at 1 m,3 m,6 m after treatment were statistical analyzed and compared between two groups. Results The NIHSS scores in minimally invasive suction therapy group were significantly lower than those in conventional clearan therapy group,the effective rate in minimally invasive suction group was significantly higher than that in the latter（ P〈0. 05）. The plasma levels of BNP,CRP and Hcy in minimally invasive suction therapy group were significantly lower than those in conventional clearan therapy group（ P〈0. 05）
出处
《河北医药》
CAS
2018年第4期526-530,共5页
Hebei Medical Journal
关键词
微创颅内血肿抽吸术
高血压脑出血
B型脑钠肽
C-反应蛋白
同型半胱氨酸
神经功能
生活质量
minimally invasive intracranial hematoma suction surgery
hypertensive cerebral hemorrhage
B typebrain natriuretic peptide
C-reactive protein
homocysteine
neural function
quality of life
