手术时间窗对外伤性脑疝术后脑梗死发生及血清SOD、MDA水平的影响

Effects of operation time window on the occurrence of cerebral infarction and serum SOD and MDA levels after traumatic cerebral hernia

目的 探究手术时间窗对外伤性脑疝术后脑梗死发生及血清超氧化物歧化酶(SOD)、丙二醛(MDA)水平的影响.方法 回顾性分析2015年6月至2019年6月江苏省海门市中医院收治的86例外伤性脑疝手术患者的临床资料,根据手术时间窗不同分为观察组与对照组,各43例.对照组手术时间窗为≥3h,观察组手术时间窗为<3h.比较2组术后脑梗死例数、数目、梗死灶范围指标及术前、术后两周血清SOD、MDA水平.结果 观察组脑梗死发生率23.26%低于对照组51.16%(P<0.05);与对照组比,观察组术后脑梗死发生平均时间延长(P<0.05);与对照组相比,观察组多发梗死率、大面积梗死率均降低,单发梗死率及小灶性梗死率均升高(P<0.05);与术前相比,术后两周2组血清SOD水平升高,且观察组高于对照组(P<0.05);血清MDA水平下降,且观察组低于对照组(P<0.05).结论 外伤性脑疝手术患者在手术时间窗<3h时可通过调节血清SOD、MDA水平有效抑制氧化应激反应,减少术后脑梗死的发生,值得推广.

Objective To investigate the effects of operation time window on the occurrence of cerebral infarction and serum SOD and MDA levels after traumatic cerebral hernia.Methods The clinical data of 86 patients admitted to jiangsu haimen hospital of traditional Chinese medicine from June 2015 to June 2019 for traumatic brain hernia surgery were retrospectively analyzed.The operative time window was≥3 h in the control group and<3 h in the observation group.The number of cases,number,range of infarcts and serum SOD and MDA levels before and two weeks after operation were compared between the two groups.Results The incidence of cerebral infarction in the observation group was 23.26%lower than that in the control group was 51.16%(P<0.05).Compared with the control group,the average time of postoperative cerebral infarction in the observation group was prolonged(P<0.05).Compared with the control group,the rates of multiple and large area infarction in the observation group were all reduced,while the rates of single infarction and small focal infarction were all increased(P<0.05).Compared with the preoperative level,the serum SOD level of the 2 groups increased two weeks after the operation,and the observation group was higher than the control group(P<0.05).Serum MDA level decreased,and the observation group was lower than the control group(P<0.05).Conclusion When the operation time window is<3 h,the patients with traumatic brain hernia can effectively inhibit the oxidative stress response by adjusting the serum SOD and MDA levels,and reduce the incidence of postoperative cerebral infarction,which is worth popularizing.