摘要
目的探讨微创颅内血肿清除术对脑出血患者血清铁蛋白与神经营养因子水平及应激反应的影响。方法选取2013年2月至2019年2月在西安北环医院治疗的80例脑出血患者,随机分为观察组(40例)和对照组(40例)。对照组患者采用常规的开颅血肿清除术,观察组采用微创颅内血肿清除术。比较2组患者治疗前和治疗后2周临床效果、血清铁蛋白(SF)、脑源性神经营养因子(BDNF)及应激反应激素水平,包括皮质醇(Cor)、促肾上腺皮质激素(ACTH)、促肾上腺皮质激素释放激素(CRH)。结果治疗后,观察组患者22例显效,15例有效,3例无效,总有效率为92%;对照组17例显效,13例有效,10例无效,总有效率为75%。观察组效果优于对照组,差异有统计学意义(P<0.05)。治疗后2周,观察组患者的SF为(304±25)ng/mL低于对照组(368±21)ng/mL,差异有统计学意义(P<0.05)。治疗后2周,观察组患者的BDNF为(3.11±0.34)ng/ml,对照组为(2.03±0.22)ng/mL,观察组高于对照组,差异有统计学意义(P<0.05)。治疗后2周,观察组患者的Cor、ACTH、CRH分别为(203±121)ng/L、(14±7)ng/L、(11±5)ng/L,对照组患者的Cor、ACTH、CRH分别为(258±119)ng/L、(22±7)ng/L、(19±5)ng/L,观察组低于对照组,差异有统计学意义(P<0.05)。结论对脑出血患者行微创颅内血肿清除术,可改善患者的神经营养因子,降低SF和应激反应水平,临床效果显著。
Objective To discuss the influences of minimally invasive evacuation of intracranial hematoma on serum ferritin and neurotrophic factor levels and stress response in patients with cerebral hemorrhage.Methods A total of 80 patients with cerebral hemorrhage from February 2013 to February 2019 in Xi′an North Ring Hospital were randomly divided into observation group(40 cases)and control group(40 cases).Patients in the control group underwent conventional craniotomy with hematoma evacuation,and the observation group underwent minimally invasive intracranial hematoma evacuation.The clinical effects,serum ferritin(SF),brain-derived neurotrophic factor(BDNF)and stress-responsive hormone levels including cortisol(Cor),adrenocorticotropic hormone(ACTH),corticotropin releasing hormone(CRH)were compared between the two groups before the treatment and two weeks after the treatment.Results After treatment,the total effective rate was 92%in the observation group and 75%in the control group,and the effect in the observation group was better than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in SF,BDNF,Cor,ACTH and CRH level between the two groups before treatment.Two weeks after treatment,SF,Cor,ACTH and CRH level of the two groups decreased,but the observation group was lower than the control group,the difference was statistically significant(P<0.05).After treatment,BDNF of the observation group and the control group were improved,but the observation group was higher than the control group,the difference was statistically significant(P<0.05).Conclusion Minimally invasive intracranial hematoma evacuation in patients with cerebral hemorrhage can improve neurotrophic factors,lower serum ferritin and stress response level,and the clinical effect is remarkable.
作者
牛晓宁
王文博
胡伟强
麻召欢
马刚
姜业臻
严驰
吴祥奎
Niu Xiaoning;Wang Wenbo;Hu Weiqiang;Ma Zhaohuan;Ma Gang;Jiang Yezhen;Yan Chi;Wu Xiangkui(Department of Surgery,Xi′an North Ring Hospital,Shaanxi 710032,China)
出处
《山西医药杂志》
CAS
2019年第23期2879-2881,共3页
Shanxi Medical Journal
关键词
外科手术
微创性
血肿
脑出血
铁蛋白
神经营养因子类
应激
Surgical procedures
minimally invasive
Hematoma
Cerebral hemorrhage
Ferritin
Neurotrophic factors
Stress
