微创颅内血肿清除术治疗脑出血的疗效观察及对患者神经功能恢复、血清炎性因子水平的影响

Curative effect of minimally invasive removal of intracranial hematoma in the treatment of cerebral hemorrhage and its influence on neurological functional recovery, serum inflammatory factor levels

目的探讨微创颅内血肿清除术治疗脑出血的疗效及对患者神经功能恢复、血清超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)水平的影响。方法选择2016年1月至2017年12月浙江新安国际医院收治的脑出血患者100例,采用随机数字表法分为对照组(常规治疗)和观察组(常规治疗加微创颅内血肿清除术)每组50例。观察两组疗效、神经功能恢复情况及hs-CRP、IL-6、IL-8、TNF-α水平。结果治疗后,两组患者出血量及血肿周围水肿量均显著下降(t=5.74、9.32、7.41、6.58,均P<0.05),且观察组较对照组显著改善(t=8.29、5.28,均P<0.05);观察组优良率90%(45/50),显著高于对照组的72%(36/50)(χ^2=3.62,P<0.05);治疗后,两组神经功能缺损(NDS)评分均较治疗前显著降低(t=4.64、5.75,均P<0.05),两组格拉斯哥昏迷(GCS)评分均较治疗前显著提高(t=5.41、7.86,均P<0.05),且观察组NDS评分均较对照组显著降低(t=5.31,P<0.05),观察组GCS评分均较对照组显著提高(t=3.84,P<0.05);两组患者各炎性因子均较治疗前显著下降(t=3.27、3.75、3.38、3.61、5.74、4.39、6.52、8.26,均P<0.05),两组比较,观察组各炎性因子均显著低于对照组(t=4.37、3.92、8.52、4.28,均P<0.05)。结论对脑出血患者在常规治疗上行微创颅内血肿清除术,疗效满意,可促进神经功能恢复,改善hs-CRP、IL-6、IL-8、TNF-α水平,值得应用。

Objective To explore the effects of minimally invasive intracranial hematoma removal in the treatment of cerebral hemorrhage, and its influence on neurological functional recovery, serum levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-8(IL-8), tumor necrosis factor-alpha (TNF-α). Methods From January 2016 to December 2017, 100 patients with cerebral hemorrhage admitted to Zhejiang Xin'an International Hospital were selected and randomly divided into two groups according to the digital table, with 50 cases in each group.The control group was given routine symptomatic treatment, the observation group received minimally invasive intracranial hematoma removal combined with conventional treatment.The curative effect, restoration of nerve function, the levels of hs-CRP, IL-6, IL-8 and TNF- were observed in the two groups. Results After treatment, the blood loss and edema volume around the hematoma in the two groups were declined significantly (t=5.74, 9.32, 7.41, 9.32, all P<0.05), and the improvements of the observation group was better than those of the control group (t=8.29, 5.28, all P<0.05). The excellent and good rate of the observation group was 90%(45/50), which was significantly higher than 72%(36/50) of the control group (χ^2=3.62, P<0.05). After treatment, the NDS scores of the two group were significantly lower than those before treatment (t=4.64, 5.75, all P<0.05), the GCS scores of the two groups were significantly improved (t=5.41, 7.86, all P<0.05). The NDS score of the observation group was significantly lower than that of the control group (t=5.31, P<0.05), the GCS score of the observation group was significantly higher than that of the control group(t=3.84, P<0.05). After treatment, the levels of inflammatory factors in the two groups were significantly reduced compared with those before treatment (t=3.27, 3.75, 3.38, 3.61, 5.74, 4.39, 6.52, 8.26, all P<0.05), the levels of inflammatory factors in the observation group were significantly lower than those in the control group (t=4.37, 3.92, 8.52, 4.28, all P<0.05). Conclusion Minimally invasive removal of intracranial hematoma combined with conventional treatment in the treatment of patients with cerebral hemorrhage can obtain satisfactory clinical effect, can promote neural functional recovery, improve inflammatory factor levels (hs-CRP, IL-6, IL-8, TNF alpha), it is worthy of application.