亚低温联合穿刺碎吸术治疗高血压脑出血的疗效及对患者血清TNF-α,IL-6,CRP水平的影响

Clinical Effect of Mild Hypothermia Combined with Puncture Aspiration Operation on the Hypertensive Intracerebral Hemorrhage and Its Effect on the Serum TNF-α,IL-6 and CRP Levels

目的:探讨亚低温联合穿刺碎吸术治疗高血压脑出血的疗效及对患者血清TNF-α、IL-6、CRP水平的影响。方法:选取我院2015年2月~2016年8月收治的112例高血压脑出血患者作为研究对象,采取随机数字表将其分成两组,每组56例。两组患者均给予微创穿刺碎吸术治疗,观察组联合给予亚低温治疗,对比两组手术疗效、并发症、短期预后及手术前后不同时点血清TNF-α、IL-6、CRP水平变化情况。结果:观察组治疗总有效率为92.86%,与对照组(76.79%)相比明显上升(P<0.05)。观察组MODS、总并发症的发生率分别为0%、26.79%,均明显低于对照组(P<0.05)。观察组术后3d、7d血清TNF-α、IL-6、CRP水平逐渐下降,且均明显低于术前(P<0.01);对照组术后3d血清TNF-α、IL-6、CRP水平与术前相比无明显变化(P>0.05),术后7d则明显下降,并显著低于术前(P<0.01);观察组术后3、7d血清TNF-α、IL-6、CRP水平均明显低于同时点对照组(P<0.01)。观察组术后3个月预后良好率为80.36%,与对照组(62.50%)比较明显上升(P<0.05)。结论:亚低温联合穿刺碎吸术治疗高血压脑出血可有效减轻神经功能缺损,抑制体内炎症反应,降低病死率,疗效确切。

Objective：To explore the clinical effect of mild hypothermia combined with puncture aspiration operation on the hypertensive intracerebral hemorrhage and its effect on the serum TNF-α,IL-6 and CRP levels.Methods：112 cases of patients with hypertensive intracerebral hemorrhage admitted in our hospital from February 2015 to August 2016 were selected as the research objectives and randomly divides into 2 groups with 56 cases in each group.Both groups were treated with minimally puncture aspiration,and mild hypothermia was performed in the observation group additionally,the clinical effect,complication,short-term prognosis,serum TNF-α,IL-6,CRP levels at different time points before and after operation were compared between two groups.Results：The overall effective rate of observation group was 92.86%,which was significantly higher than of the control group（76.79%.P〈0.05）.The incidence of MODS and complications were 0% and 26.79% respectively,which were significantly lower than those of the control group（P〈0.05）.The serum TNF-α,IL-6,CRP levels of observation group were significantly decreased on the 3rd and 7th day postoperation,which were significantly lower than those before operation（P〈0.01）.The serum TNF-α,IL-6,CRP levels of control group on the 3rd day postoperation were similar to those before operation（P〉0.05）,but the serum TNF-α,IL-6,CRP levels on the 7th day postoperation were significantly decreased（P〈0.01）.The serum TNF-α,IL-6,CRP levels on the 3rd,7th day postoperation were significantly lower than those of the control group at same time points（P〈0.01）.The favorable prognosis of observation group was 80.36%,which was significantly higher than that of the control group（62.50%,P〈0.05）.Conclusion：Mild hypothermia combined with puncture aspiration operation could effectively reduce the neurological deficits,inhibit the inflammatory response and decrease the mortality.