经侧裂显微手术治疗高血压脑出血的临床效果及安全性分析

Clinical Efficacy and Safety of Transsylvian Microsurgery on Hypertensive Intracerebral Hemorrhage

目的:分析经侧裂显微手术治疗高血压脑出血的临床效果及安全性。方法:随机从2016年5月-2018年11月笔者所在医院收治的高血压脑出血患者中抽取80例进行研究,采用随机数字法将其分为两组,每组40例。对照组接受小骨窗开颅术治疗,研究组接受经侧裂显微手术治疗。观察比较两组临床疗效、并发症发生情况、血压水平及IL-1β、TNF-α、S100β蛋白、NSE水平。结果:研究组治疗总疗效率为95.00%,高于对照组的60.00%,差异有统计学意义(P<0.05)。研究组并发症总发生率为5.00%,低于对照组的35.00%,差异有统计学意义(P<0.05)。治疗前两组DBP、SBP水平比较,差异无统计学意义(P>0.05);治疗后,研究组DBP、SBP低于对照组,差异有统计学意义(P<0.05)。治疗前两组S100β蛋白、NSE、IL-1β、TNF-α比较,差异无统计学意义(P>0.05);治疗后,研究组S100β蛋白、NSE、IL-1β、TNF-α均低于对照组,差异有统计学意义(P<0.05)。结论:经侧裂显微手术治疗高血压脑出血,效果优于小骨窗开颅术,血压恢复速度快,并发症发生率低,值得推广。

Objective:To analyze the clinical efficacy and safety of transsylvian microsurgery for hypertensive intracerebral hemorrhage.Method:A total of 80 patients with hypertensive intracerebral hemorrhage admitted in our hospital from May 2016 to November 2018 were randomly selected for the study.They were divided into two groups by random number method,40 cases in each group.The control group was treated with small bone window craniotomy,and the study group was treated with transsylvian microsurgery.The clinical efficacy,complications,blood pressure,IL-1β、TNF-α,S100β protein and NSE levels were observed and compared between the two groups.Result:The total curative effect rate of the study group was 95.00%,which was higher than 60.00% of the control group,the difference was statistically significant(P<0.05).The total incidence of complications in the study group was 5.00%,which was lower than 35.00% in the control group,the difference was statistically significant(P<0.05).There were no statistically significant differences in DBP and SBP levels between the two groups before treatment(P>0.05).After treatment,DBP and SBP in the study group were lower than those in the control group,and the difference were statistically significant(P<0.05).There were no significant differences in S100β protein,NSE,IL-1βand TNF-α between the two groups before treatment(P>0.05).After treatment,S100β protein,NSE,IL-1βand TNF-α in the study group were all higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion:The transsylvian microsurgery is superior to small bone window craniotomy in the treatment of hypertensive intracerebral hemorrhage,with fast blood pressure recovery and low incidence of complications.