摘要
目的观察神经内镜下脑出血清除术联合置管引流治疗急性脑出血脑室破入患者的临床效果。方法选择2010年1—2021年5月保定市第一中心医院就诊的急性脑出血脑室破入患者84例,依照随机数字表法分为两组,各42例。对照组采用置管引流联合显微镜下脑出血清除术,观察组采用置管引流联合神经内镜下脑出血清除术。比较两组手术时间、术中出血量、置管时间、住院时间;比较两组术后1、3、7 d脑室内、脑实质血肿清除率;比较术前与术后1、7 d两组血清C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平;术后7 d,比较两组格拉斯哥预后评分法(GOS)及颅内感染发生情况。结果两组患者术中出血量手术时间对比差异无统计学意义(P>0.05),观察组置管时间、住院时间均比对照组短(P<0.05);术后3 d、术后7 d两组脑室内、脑实质血肿清除率均高于术后1 d(P<0.05),术后7 d两组脑室内、脑实质血肿清除率均高于术后3 d(P<0.05),且术后1、3、7 d观察组脑室内血肿清除率均高于对照组(P<0.05);术后1、7 d两组血清CRP、TNF-α水平均低于术前(P<0.05),术后7 d两组血清CRP、TNF-α水平低于术后1 d(P<0.05),且术后1、7 d观察组血清TNF-α、CRP水平均比对照组低(P<0.05);术后7 d,观察组GOS评分比对照组低(P<0.05);观察组颅内感染率比对照组低(P<0.05)。结论神经内镜下脑出血清除术联合置管引流治疗急性脑出血脑室破入患者可缩短住院时间及置管时间,减轻机体炎症反应,增强清除脑室内血肿能力,改善近期预后,且降低颅内感染的发生。
Objective To observe the clinical effect of neuroendoscopic cerebral hemorrhage debridement combined with catheter drainage in the treatment of acute cerebral hemorrhage with ventricular rupture.Methods A total of 84 patients with acute cerebral hemorrhage ruptured into the ventricle from January 2010 to May 2021 were selected and divided into 2 groups according to random number method,with 42 cases in each group.The control group used catheter drainage combined with microscopic cerebral hemorrhage clearance,and the observation group used catheter drainage combined with neuroendoscopic cerebral hemorrhage clearance.The operation time,intraoperative blood loss,catheterization time,and hospital stay were compared between the two groups.The intraventricular and parenchymal hematoma clearance rates were compared between the two groups at 1 d,3 d,and 7 d after operation.The levels of serum C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)were compared between the two groups before operation,1 d,and 7 d after operation.At 7 days after operation,the Glasgow Outcome Score(GOS)and the incidence of intracranial infection were compared between the two groups.Results There were no significant difference in intraoperative blood loss and operation time between the two groups(P>0.05).The catheterization time and hospital stay in the observation group were low and the control group was short(P<0.05).The intraventricular and parenchymal hematoma clearance rates of the two groups at 3 d and 7 d after operation were higher than those at 1 d after operation(P<0.05).The intraventricular and parenchymal hematoma clearance rates of the two groups at 7 days after operation were higher than those at 3 days after operation(P<0.05),and the clearance rate of intraventricular hematoma in the observation group was higher than that in the control group at 1d,3d and 7d after operation(P<0.05).Serum CRP and TNF-αlevels in the two groups were lower than before operation on the 1st and 7th day after operation(P<0.05),and on the 7th day
作者
闫亮
刘嫚
王佳
YAN Liang;LIU Man;WANG Jia(Department of Neuro-intensive Medicine,Baoding First Central Hospital,Baoding Hebei 071000,China)
出处
《中国急救复苏与灾害医学杂志》
2022年第8期1055-1058,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
河北省医学科学研究重点计划项目(编号:20181011)。
关键词
神经内镜下脑出血清除术
置管引流
急性脑出血脑室破入
预后
Neuroendoscopic intracerebral hemorrhage removal
Catheterization and drainage
Acute intracerebral hemorrhage
Ventricular rupture
Prognosis
