标准大骨瓣减压术与常规去骨瓣减压术治疗大面积脑栓塞患者血清BNP及血管内皮素水平变化的临床研究

Clinical Study on Serum BNP and Endothelin Levels Changes of Patients with Cerebral Embolism Undergoing Standard Decompressive Craniectomy and Conventional Decompressive Craniectomy

目的研究采用标准大骨瓣减压术治疗大面积脑栓塞患者血清BNP(脑钠肽)及血管内皮素水平的变化。方法选取在我院接受大面积脑栓塞治疗的患者60例,分为两组。观察组采用标准大骨瓣减压术进行治疗,而对照组则采用常规的大骨瓣减压术进行治疗。检测患者治疗前后的BNP和ET(内皮素)的水平,CT检查其脑栓塞面积,给予格拉斯哥昏迷评分(GCS评分)。结果治疗7 d和14 d后,观察组的GCS评分显著高于对照组(P<0.05);治疗7 d后,观察组的脑栓塞面积明显小于对照组(P<0.05);治疗后10 d,观察组的BNP和ET水平均明显优于对照组(P<0.05)。结论标准大骨瓣减压术在治疗大面积脑栓塞时疗效显著,且能有效降低BNP和ET的表达水平,有利于术后康复。

Objective To study the serum BNP （brain natriuretic peptide） and endothelin levels changes of patients with large-area cerebral embolism undergoing standard decompressive craniectomy. Methods 60 cases of patients with large-area cerebral embolism admitted to our hospital were selected and divided into two groups. The observation group received standard decompressive craniectomy, while the control group received conventional decompressive craniectomy. The levels of BNP and ET （endothelin） of patients were detected before and after treatment. CT examination was used to detected the area of cerebral embolism and the Glasgow coma scale （GCS） score was given. Results 7 days and 14 days after treatment, the GCS score of observation group was significantly higher than that of control group （P 〈0.05）. 7 days after treatment, The area of cerebral embolism of observation group was significantly smaller than that control group （P 〈 0.05）. 10 days after treatment, the levels of BNP and ET of observation group were significantly better than those of control group （P〈0.05）. Conclusions The standard decompressive craniectomy in the treatment of large-area cerebral embolism has significant effect and can effectively reduce the expression levels of BNP and ET, which helps for postoperative rehabilitation.