立体定向-改良软通道微创介入颅内血肿清除术治疗高血压脑出血的效果

Effect of Stereotactic-Modified Soft-Channel Minimally Invasive Intracranial Hematoma Evacuation in Patients with Hypertensive Intracerebral Hemorrhage

目的分析立体定向-改良软通道微创介入颅内血肿清除术(以下简称“立体定向改良术”)治疗高血压脑出血(HICH)患者的效果。方法回顾性选取2017年9月至2019年12月温县人民医院收治的86例HICH患者临床资料,将接受立体定向改良术治疗的44例作为观察组,接受硬通道颅内血肿清除术(以下简称“清除术”)的42例作为对照组,比较两组手术时长、术中失血量、血肿引流及住院时间、血肿清除率、美国国立卫生研究院卒中量表(NIHSS)评分、血清S100β蛋白(S100β)、神经元特异性烯醇化酶(NSE)、白细胞介素(IL)-6水平、并发症发生情况。结果与对照组比较,观察组手术时间、血肿引流时间、住院时间较短,血肿清除率较高(P<0.05);治疗7、14 d后,观察组NIHSS评分均较对照组低(P<0.05);治疗7 d后,观察组血清S100β、NSE、IL-6水平均低于对照组(P<0.05);观察组并发症发生率较对照组低(P<0.05)。结论采用立体定向改良术治疗HICH,能有效提高血肿清除率,减轻脑组织损伤,改善神经功能,且具有手术、血肿引流、住院时间短及并发症少的优势。

Objective To analyze the effect of stereotactic-modified soft-channel minimally invasive intervention for intracranial hematoma removal(hereinafter referred to as“stereotactic modified intervention”)in patients with hypertensive intracerebral hemorrhage(HICH).Methods A total of 86 patients with HICH hospitalized in Wenxian People’s Hospital from September 2017 to December 2019 were retrospectively selected.Forty-four patients who received stereotactic modified surgery were selected as observation group,and 42 patients who received hard channel intracranial hematoma removal(hereinafter referred to as“removal”)were selected as control group.The operation time,intraoperative blood loss,hematoma drainage time and hospitalization time,hematoma clearance rate,National Institute of Health Stroke Scale(NIHSS)scores,serum S100βprotein(S100β),neuron-specific enolase(NSE),interleukin(IL)-6 levels and complications were compared between the two groups.Results Compared with control group,the operation time,hematoma drainage time and hospitalization time of observation group were shorter,and the hematoma clearance rate was higher(P<0.05).After 7 and 14 days of treatment,the NIHSS scores of observation group were lower than those of control group(P<0.05).The serum levels of S100β,NSE and IL-6 in observation group were lower than those in control group after 7 days of treatment(P<0.05).The incidence of complications in observation group was lower than that in control group(P<0.05).Conclusion Stereotactic-modified soft-channel minimally invasive intracranial hematoma evacuation for HICH patients could effectively improve hematoma clearance rate,alleviate brain tissue damage,improve neurological function,and has the advantages of shorter operation time,hematoma drainage,short hospitalization time and fewer complications.