摘要
目的:探讨神经内镜下血肿清除术对老年高血压脑出血(HICH)患者神经功能、血清丙二醛(MDA)、神经胶质纤维酸性蛋白(GFAP)水平的影响。方法:回顾性分析85例老年HICH患者临床资料,其中43例行神经内镜下血肿清除术(内镜组),42例行开颅血肿清除术(CHR)(传统组)。对比两组手术一般情况、术后并发症,术前、术后7 d美国国立卫生院卒中量表(NIHSS)评分、改良巴氏指数(BI)评分、血清MDA、GFAP水平及随访6个月格拉斯哥预后评估量表(GOS)评分。结果:与传统组相比,内镜组手术时间和住院时间均较短,且术中失血量较少,血肿清除率较高(t=6.246、26.265、7.002、8.834,P<0.05);术后7 d,内镜组NIHSS评分、BI评分及血清MDA、GFAP水平均优于传统组(t=4.387、3.449、9.146、6.639,P<0.05);内镜组术后并发症发生率低于传统组,差异有统计学意义(11.63%vs.30.95%,χ^(2)=4.753,P=0.029);术后随访6个月,内镜组GOS评分高于传统组(t=6.341,P<0.05)。结论:神经内镜下血肿清除术治疗老年HICH安全有效,可改善围术期指标,促进术后神经功能及生活能力恢复,并降低血清MDA、GFAP水平。
Objective:To explore the effects of neuroendoscopic hematoma evacuation on nerve function,levels of serum malondialdehyde(MDA)and glial fibrillary acidic protein(GFAP)in elderly patients with hypertensive intracerebral hemorrhage(HICH).Methods:A retrospective analysis was performed on the data of 85 elderly patients with HICH,including 43 undergoing neuroendoscopic hematoma evacuation in neuroendoscopy group and 42 cases including craniotomy hematoma evacuation(CHR)in traditional group.The general surgical conditions,postoperative complications,scores of National Institutes of Health Stroke Scale(NIHSS)and modified Barthel index(BI),levels of serum MDA and GFAP before and at 7 d after surgery were compared between the two groups,and Glasgow Outcome Scale(GOS)within 6 months of follow-up in both groups were statistically analyzed.Results:Compared with traditional group,operation time and hospitalization time were shorter,intraoperative blood loss was less,and hematoma clearance rate was higher in neuroendoscopy group(t=6.246,26.265,7.002,8.834,P<0.05).At 7 d after surgery,NIHSS and BI scores,levels of serum MDA and GFAP in neuroendoscopy group were better than those in traditional group(t=4.387,3.449,9.146,6.639,P<0.05).The incidence of postoperative complications in neuroendoscopy group was lower than that in traditional group,the difference was statistically significant(11.63%vs.30.95%,χ^(2)=4.753,P=0.029).After 6 months of postoperative follow-up,GOS score in neuroendoscopy group was higher than that in traditional group(t=6.341,P<0.05).Conclusion:Neuroendoscopic hematoma evacuation is safe and effective in the treatment of elderly HICH,which can improve the perioperative indicators of patients,promote the recovery of postoperative neurological function and living ability,and reduce serum MDA and GFAP levels.
作者
张志强
杨珉
许先平
李光胡
王健鹏
钱晟
ZHANG Zhi-qiang;YANG Min;XU Xian-ping;LI Guang-hu;WANG Jian-peng;QIAN Sheng(Department of Neurosurgery,Affiliated Hospital of Jianghan University,Wuhan Sixth Hospital,Wuhan 430014,Hubei,China)
出处
《川北医学院学报》
CAS
2022年第5期597-600,共4页
Journal of North Sichuan Medical College
基金
湖北省教育厅科学研究计划指导性项目(B2021064)。
关键词
高血压脑出血
老年患者
神经内镜
血肿清除术
神经功能
丙二醛
神经胶质纤维酸性蛋白
Hypertensive intracerebral hemorrhage
Elderly patient
Neuroendoscopy
Hematoma evacuation
Nerve function
Malondialdehyde
Glial fibrillary acidic protein
