软通道微创治疗对高血压脑出血患者感染及炎性指标的控制效果观察

Effect of soft-channel minimally invasive surgery on control of infection and inflammatory indexes of patients with hypertensive intracerebral hemorrhage

目的探讨软通道微创治疗对高血压脑出血患者炎性指标的影响,为临床手术治疗高血压脑出血提供参考借鉴。方法选取医院2013年12月-2014年12月临床收治的高血压脑出血患者66例,根据患者手术情况分成软通道组(给予软通道微创手术)和硬通道组(给予硬通道微创手术),各33例,比较两组患者的感染率、治疗有效率、炎性指标和应激状态指标。结果软通道组患者感染率为0,显著低于硬通道组12.12%;软通道组患者总有效率为93.94%,显著高于硬通道组75.76%;术后软通道组患者CRP、TNF-α和PCT水平分别为(23.65±17.14)mg/l、(1.10±0.31)ng/ml和(0.10±0.01)μg/ml,显著低于硬通道组(39.01±19.22)mg/l、(1.55±0.65)ng/ml和(0.23±0.02)μg/ml,且差异有统计学意义(P<0.05);术后软通道组患者Cor、NE、5-HT和ALD水平分别为(221.23±19.23)ng/ml、(250.23±10.23)ng/ml、(170.23±19.23)ng/ml和(26.34±3.11)ng/L,显著低于硬通道组(271.23±20.23)ng/ml、(280.11±11.23)ng/ml、(207.18±19.22)ng/ml和(40.32±6.43)ng/L,且差异有统计学意义(P<0.05)。结论在临床针对高血压脑出血患者实施治疗的实践过程中,采用软通道微创治疗方法可以有效降低患者的临床感染率,有效控制患者的炎性指标并显著改善患者的临床应激状态,是临床手术治疗高血压脑出血患者的理想方式之一。

OBJECTIVE To explore the influence of soft-channel minimally invasive surgery on inflammatory indexes of patients with hypertensive intracerebral hemorrhage so as to provide guidance for surgical treatment of the patients with hypertensive intracerebral hemorrhage.METHODS A total of 66 patients with hypertensive intracerebral hemorrhage who were treated in the hospital from Dec 2013 to Dec 2014 were enrolled in the study and divided into the soft-channel group（soft-channel minimally invasive surgery）and the hard-channel group（hard-channel minimally invasive surgery）according to the mode of surgery,with 33 cases in each group.The incidence rate of infections,effective rate of treatment,inflammatory indexes,and stress state indexes were observed and compared between the two groups of patients.RESULTS The incidence rate of infections of the soft-channel group was 0%,significantly lower than 12.12% of the hard-channel group.The total effective rate of treatment of the soft-channel group was 93.94%,significantly higher than 75.76% of the hard-channel group.The levels of CRP,TNF-α,and PCT of the soft-channel group were respectively（23.65±17.14）mg/l,（1.10±0.31）ng/ml,and（0.10±0.01）μg/ml after the surgery,remarkably lower than（39.01±19.22）mg/l,（1.55±0.65）ng/ml,and（0.23±0.02）μg/ml of the hard-channel group,and there was significant difference（P〈0.05）.The levels of Cor,NE,5-HT,and ALD of the soft-channel group were respectively（221.23±19.23）ng/ml,（250.23±10.23）ng/ml,（170.23±19.23）ng/ml,and（26.34±3.11）ng/L after the surgery,significantly lower than（271.23±20.23）ng/ml,（280.11±11.23）ng/ml,（207.18±19.22）ng/ml,and（40.32±6.43）ng/L of the hard-soft channel group（P〈0.05）.CONCLUSIONIn response to the clinical treatment of the patients with hypertensive intracerebral hemorrhage,the soft-channel minimally invasive surgery can effectively reduce the incidence rate of clinical infections and effectively control the inflammatory indexes of the patients as well as improve the clinical stress state,and it is one of the ideal approaches for cliical surgical treatment of the patients with hypertensive intracerebral hemorrhage.