软通道微创引流术对老年脑出血患者神经功能及血清氧化应激指标的影响

Effects of soft channel minimally invasive drainage on neurological function and serum oxidative stress indexes in elderly patients with cerebral hemorrhage

目的:探讨软通道微创引流术对老年脑出血患者神经功能及血清氧化应激指标的影响。方法:回顾性分析我院2019年7月至2021年7月收治的107例老年脑出血患者的临床治疗资料,根据手术方式不同进行分组,其中进行硬通道微创引流术的患者为对照组(59例),进行软通道微创引流术的患者为观察组(48例)。采用酶联免疫吸附法检测血清神经元特异性烯醇化酶(NSE)、神经肽(NP)Y、脑源性神经营养因子(BDNF)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平;采用分光度法检测血清谷胱甘肽过氧化物酶(GSH-Px)水平;采用美国国立卫生研究院脑卒中量表(NIHSS)评估患者神经功能,Barthel指数量表评估患者日常生活能力。比较两组血清神经功能因子、氧化应激指标、神经功能、日常生活能力及术后并发症情况。结果:两组患者手术后的血清NSE、NPY水平均降低,且观察组低于对照组(P<0.05);两组患者手术后的血清BDNF水平均升高,且观察组高于对照组(P<0.05)。两组患者手术后的血清SOD、GSH-Px均升高,且与对照组相比观察组更高(P<0.05);两组患者手术后的血清MDA水平降低,且与对照组相比观察组更低(P<0.05)。两组患者手术后的NIHSS评分均降低,且与对照组相比观察组更低(P<0.05)。两组患者手术后的Barthel指数评分均升高,且对照组相比观察组更高(P<0.05)。对照组患者术后并发症发生率明显高于观察组(20.34%vs 4.17%)(χ^(2)=6.087,P=0.014)。结论:采用软通道微创引流术能够改善老年脑出血患者神经功能,减轻氧化应激反应,提高日常生活能力,且术后并发症少,有临床推广的价值。

Objective:To investigate the effect of soft channel minimally invasive drainage on neurological function and serum oxidative stress indexes in elderly patients with cerebral hemorrhage.Methods:The clinical treatment data of 107 elderly patients with cerebral hemorrhage admitted to our hospital from July 2019 to July 2021 were retrospectively analyzed,and they were grouped according to different surgical methods.The patients who underwent hard channel minimally invasive drainage were the control group(59 cases),and the patients who underwent soft channel minimally invasive drainage were the observation group(48 cases).Serum neuron-specific enolase(NSE),neuropeptide(NP)Y,brain-derived neurotrophic factor(BDNF),superoxide dismutase(SOD),malondialdehyde(MDA)were detected by enzyme-linked immunosorbent assay,and serum glutathione peroxidase(GSH-Px)level was detected by spectrophotometry.The neurological deficit before and after surgery was assessed by the National Institutes of Health Stroke Scale(NIHSS).Barthel index Table was used to assess patients'ability of daily living before and after surgery.The serum neurological function factors,oxidative stress indicators,neurological deficits,daily living ability and postoperative complications were compared in two groups.Resuits:The serum NSE and NPY levels of the two groups of patients after surgery were decreased,and the NSE and NPY in observation group was lower compared with the control group(P<0.05).The serum SOD and GSH-Px of the two groups of patients after surgery were increased,and compared with the control group,the SOD and GSH-Px of observation group was higher(P<0.05).The NIHSS scores of the two groups after surgery were decreased,and compared with the control group,the NIHSS score of observation group was lower(P<0.05).The Barthel index scores of the two groups were increased after surgery,and the Barthel index score of observation group was higher compared with the control group(P<0.05).The rate of postoperative complications in the control group was significantly higher than that in the observation group(20.34%vs 4.17%)(X^(2)=6.087.P=0.014).Conclusion;The use of soft channel minimally invasive drainage can improve the neurological function of elderly patients with cerebral hemorrhage,reduce oxidative stress,and improve the daily living ability of patients.