微创颅内血肿抽吸术治疗创伤性脑出血的临床效果及其对神经功能的影响

Clinical Effect of Minimally Invasive Intracranial Hematoma Aspiration in Treating Traumatic Cerebral Hemorrhage and the Impact on Neurological Function

目的分析微创颅内血肿抽吸术治疗创伤性脑出血的临床效果及其对神经功能的影响。方法选取2014年4月—2017年4月江油市九〇三医院收治的创伤性脑出血患者64例,根据治疗方法分为对照组30例与观察组34例。对照组患者行内科保守治疗,观察组患者在对照组基础上行微创颅内血肿抽吸术。比较两组患者临床效果,治疗前及治疗后1个月血-脑脊液屏障指数、美国国立卫生研究院卒中量表(NIHSS)评分、血清肿瘤坏死因子α(TNF-α)水平、血清白介素6(IL-6)水平、血肿量及血肿周围水肿量,并观察两组患者不良反应/并发症发生情况。结果观察组患者临床效果优于对照组(P<0.05)。治疗前两组患者血-脑脊液屏障指数、NIHSS评分比较,差异无统计学意义(P>0.05);治疗后1个月观察组患者血-脑脊液屏障指数、NIHSS评分低于对照组(P<0.05)。治疗前两组患者血清TNF-α、IL-6水平比较,差异无统计学意义(P>0.05);治疗后1个月观察组患者血清TNF-α、IL-6水平低于对照组(P<0.05)。治疗前两组患者血肿量、血肿周围水肿量比较,差异无统计学意义(P>0.05);治疗后1个月观察组患者血肿量、血肿周围水肿量小于对照组(P<0.05)。两组患者不良反应/并发症发生率比较,差异无统计学意义(P>0.05)。结论微创颅内血肿抽吸术治疗创伤性脑出血的临床效果确切,可有效清除血肿、减轻血肿周围水肿程度,改善患者神经功能。

Objective To analyze the clinical effect of minimally invasive intracranial hematoma aspiration in treating traumatic cerebral hemorrhage and the impact on neurological function. Methods A total of 64 patients with traumatic cerebral hemorrhage were selected in 903 rd Hospital of Jiangyou from April 2014 to April 2017,and they were divided into control group（ n = 30） and observation group（ n = 34） according to therapeutic methods. Patients of control group received conservative medical management,while patients of observation group received minimally invasive intracranial hematoma aspiration based on conservative medical management. Clinical effect,blood-cerebrospinal fluid barrier index,NIHSS score,serum levels of TNF-α and IL-6,hematoma volume,edema volume around hematoma before and after 1 month of treatment were compared between the two groups,and incidence of adverse reactions/complications was observed. Results Clinical effect of observation group was statistically significantly better than that of control group（ P 0. 05）. No statistically significant differences of blood-cerebrospinal fluid barrier index or NIHSS score was found between the two groups before treatment（ P 0. 05）,while blood-cerebrospinal fluid barrier index and NIHSS score of observation group were statistically significantly lower than those of control group after 1 month of treatment（ P 0. 05）. No statistically significant differences of serum level of TNF-α or IL-6 was found between the two groups before treatment（ P 0. 05）, while serum levels of TNF-α and IL-6 of observation group were statistically significantly lower than those of control group after 1 month of treatment（ P 0. 05）. No statistically significant differences of hematoma volume or edema volume around hematoma was found between the two groups before treatment（ P 0. 05）,while hematoma volume and edema volume around hematoma of observation group were statistically significantly less than those of control group（ P 0. 05）. No statistically significant differences of incidence of adverse reactions/complications（ P 0. 05）. Conclusion Minimally invasive intracranial hematoma aspiration has certain clinical effect in treating traumatic cerebral hemorrhage,can effectively remove the hematoma,relive the peripheral edema degree and improve the neurological function.