神经内镜联合脑室外引流术对脑室出血患者神经功能和炎症因子的影响

Effect of neuroendoscopic combined with external ventricular drainage on neurological function and inflammatory factors in patients with ventricular hemorrhage

目的探讨神经内镜手术联合脑室外引流术对脑室出血患者神经功能和炎症因子的影响。方法选取脑室出血患者108例,其中52例采用脑室外引流术治疗(引流组),56例采用神经内镜联合脑室外引流术治疗(联合组),比较2组患者围术期指标和术前、术后3 d、术后7 d的炎症因子水平以及术前、术后15 d、术后30 d的神经功能状况,记录2组患者并发症发生情况。结果联合组患者住院时间、脑脊液恢复正常时间、血肿清除时间、手术时间、引流管置管时间均短于引流组(P<0.05),术后1 d血肿残余量少于引流组(P<0.05)。2组患者术后3 d、7 d的血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)水平低于术前,均呈下降趋势(P<0.05),且联合组低于引流组(P<0.05)。2组患者术后15 d、30 d美国国立卫生研究院卒中量表(NIHSS)评分低于术前,均呈下降趋势(P<0.05),且联合组低于引流组(P<0.05)。2组患者并发症发生率比较,差异无统计学意义(P>0.05)。结论在常规脑室外引流术的基础上辅以神经内镜治疗脑室出血,可有效减轻神经功能损伤,降低炎症因子水平,促进患者术后恢复,安全性高。

Objective To investigate the effect of neuroendoscopic combined with external ventricular drainage on neurological function and inflammatory factors in patients with ventricular hemorrhage.Methods A total of 108 patients with ventricular hemorrhage were selected,among which 52 cases were treated with external ventricular drainage(the drainage group),56 cases were treated with neuroendoscopic combined with external ventricular drainage(the combined group).The perioperative indicators and inflammatory factors levels before operation,3 days after operation,7 days after operation and neurological function before operation,15 days after operation,30 days after operation were compared between two groups,and the incidence of complications in both groups were recorded.Results The hospitalization time,cerebrospinal fluid recovery time,hematoma clearance time,operation time,drainage tube placement time in the combined group were shorter than those in the drainage group(P<0.05),the residual volume of hematoma 1 day after operation was less than that in the drainage group(P<0.05).The serum levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),procalcitonin(PCT)3 days after operation,7 days after operation in the two groups decreased compared with before operation(P<0.05),and the serum levels of IL-6,TNF-α,PCT 3 days after operation,7 days after operation in the combined group were lower than those in the drainage group(P<0.05).The National Institutes of Health Stroke Scale(NIHSS)scores 15 days after operation,30 days after operation in the two groups showed a downward trend compared with those before operation(P<0.05),and the NIHSS scores in the combined group were lower than those in the drainage group 15 days after operation,30 days after operation(P<0.05).There was no statistically significant difference in the incidence of complications between two groups(P>0.05).Conclusion On the basis of conventional external ventricular drainage,supplemented with neuroendoscopy to treat ventricular hemorrhage,it can effectively reduce the neurological function damage,reduce the level of inflammatory factors,and promote the postoperative recovery of patients with high safety.