经外侧裂入路手术治疗高血压基底节区脑出血后TNF-a的表达研究

Clinical Research of TNF-a of Hypertension Basal Ganglia Region Cerebral Hemorrhage Treateol Through Lateral Fissure of Cerebrum Region Under Microscope

目的观察显微镜下经侧裂入路治疗60例高血压基底节区脑出血的疗效及TNF-a的表达。方法回顾分析2011年1月至2011年6月在我院神经外科住院治疗高血压基底节脑出血患者60例，根据出血量多少分为30～40mL（A组20例）、40—50mL（B组20例）、〉50mL（C组20例）；所有患者均行显微镜下经侧裂-岛叶入开颅血肿清除术治疗，于术前、术后6h、1d、2d、3d、7d采集患者静脉血标本检测TNF-a；随访半年至1年，观察其格拉斯哥预后分级（GOS）。结果三组患者术后TNF-a的表达均较术前降低，术后均逐渐增加，3d达高峰，3d后逐渐降低；颅内出血量越大、TNF—a表达越高；GOS分级比较，出血量越大、预后越差。结论显微镜下经侧裂入路治疗高血压基底节区脑出血的临床效果可靠，患者预后与出血量多少及炎症反应轻重有关。

Objective Observing the clinical research and TNF-a expression of treating 60 hypertension basal ganglia re- gion cerebral hemorrhage through lateral fissure of cerebrum region under microscope. Methods Retrospective analysis the 60 pa- tients of hypertension basal ganglia region cerebral hemorrhage who were operated through lateral fissure of cerebrum region under microscope in our hospital from January 2011 to June; dividing into 30 - 40mL（ A group） ,40 - 50mL（ B group）, 〉 50mL（ C group） ;checking TNF-a before and after the operation;observing GOS after half a year;Results TNF-a expression reduce after the operation,then slightly increase ,3d reach the top, then reduce, which is connected with the intracerebral hemorrhagic volume; The intracerebral hemorrhagic volume is biger, the GOS is smaller;Conclusion The clinical effect of treating 60 hypertension basal ganglia region cerebral hemorrhage throughlateral fissure of cerebrum region under microscope is reliable ,which is an effective sur- gical procedure treating hypertension basal ganglia region cerebral hemorrhage, the GOS is connected with the intracerebral hemor- rhagic volume and the TNF-a expression