摘要
目的探讨神经内镜辅助脑室外引流(EVD)对脑室出血(IVH)患者的临床疗效、脑微循环及血清相关因子的影响。方法选择2020年7月至2022年6月于我院行EVD的IVH患者86例,依据随机数字表法分为内镜组与对照组各43例。对照组行EVD,内镜组在神经内镜辅助下行EVD。观察两组手术时间、留置引流管时间、术后1 d残余血肿量、血肿清除时间、住院时间等围术期指标;两组术前、术后7 d血小板计数(PLT)、血小板聚集率(PAG)及纤维蛋白原(Fib)等脑微循环指标;血清轴突生长抑制因子A(Nogo-A)、正五聚蛋白3(PTX3)、成纤维细胞生长因子受体-1(FGFR-1)等血清相关因子水平;两组患者神经功能及术后并发症。结果内镜组手术时间、留置引流管时间、术后1 d残余血肿量、血肿清除时间、住院时间等围术期指标均少于对照组(P<0.05);术后7 d,内镜组PLT、PAG及Fib水平低于对照组(P<0.05);血清Nogo-A、PTX3水平及NIHSS评分均低于对照组,FGFR-1水平均高于对照组(P<0.05);内镜组总有效率大于对照组,术后并发症发生率低于对照组(P<0.05)。结论神经内镜辅助EVD可提高IVH临床疗效,增强脑微循环,改善血清相关因子水平,促进神经功能恢复,术后恢复快,并发症少。
Objective To investigate the effects of neuroendoscopy-assisted external ventricular drainage(EVD)on clinical efficacy,cerebral microcirculation and serum-related factors in patients with intraventricular hemorrhage(IVH).Methods A total of 86 IVH patients who received EVD in our hospital from July 2020 to June 2022 were selected.The patients were divided into an endoscopy group and a control group according to random number table method,43 in each group.The control group received EVD,and the endoscopy group received neuroendoscopy-assisted EVD.Perioperative indexes such as operation time,catheter retention time,residual hematoma after one day of operation,hematoma clearance time and hospital stay were observed in the two groups.Before and after 7 days of operation,cerebral microcirculation such as platelet count(PLT),platelet aggregation rate(PAG)and fibrinogen(Fib),and serum related factors such as neurite outgrowth inhibitor-A(Nogo-A),pentamerin 3(PTX3)and fibroblast growth factor receptor-1(FGFR-1)were observed in the two groups.Neurological function and postoperative complications were also observed in the two groups.Results Perioperative indexes such as operation time,catheter retention time,residual hematoma after one day of surgery,hematoma clearance time,and hospital stay time in the endoscopy group were shorter or lower than those in the control group(P<0.05).After 7 days of operation,the levels of PLT,PAG and Fib of the endoscopy group were lower than those of the control group(P<0.05).After 7 days of operation,the levels of Nogo-A,PTX3 and NIHSS were lower and FGFR-1 level was higher in the endoscopy group than those in the control group(P<0.05).The total effective rate of the endoscopy group was higher than that of the control group(P<0.05).The incidence of postoperative complications in the endoscopy group was lower than that in the control group(P<0.05).Conclusions Neuroendoscope-assisted EVD can improve the clinical efficacy of IVH,enhance the cerebral microcirculation,improve the level of serum-re
作者
尚彬
陈华轩
罗波
张渊
云德波
SHANG Bin;CHEN Hua-xuan;LUO Bo;ZHANG Yuan;YUN De-bo(Department of Neurosurgery,Nanchong Central Hospital,Nanchong 637000,China)
出处
《实用医院临床杂志》
2023年第3期83-87,共5页
Practical Journal of Clinical Medicine
基金
南充市科技局科技计划项目(编号:18SXHZ0331)。
关键词
神经内镜
脑室外引流
脑室出血
临床疗效
脑微循环
血清相关因子
Neuroendoscopy
External ventricular drainage
Intraventricular hemorrhage
Clinical efficacy
Cerebral microcirculation
Serum-related factor
