经额锁孔入路手术治疗重型脑室出血患者的效果及对患者脑血流动力学的影响

Effect of Transfrontal Keyhole Approach in the Treatment of Severe Intraventricular Hemorrhage and Its Influence on Cerebral Hemodynamics

目的:经额锁孔入路手术治疗重型脑室出血患者的效果及对患者脑血流动力学的影响。方法:选取2019年6月-2020年6月本院收治的92例重型脑室出血患者进行研究,按照随机数字法分为对照组(n=46)和研究组(n=46)。对照组进行钻颅脑室外引流手术治疗,研究组进行经额锁孔入路手术治疗。观察分析两组血肿清除率、脑血流动力学、炎性介质及神经功能情况。结果:与对照组相比,研究组血肿清除率高(P<0.05);与对照组相比,治疗后,研究组Vm及PI值高(P<0.05),RI值低(P<0.05);与对照组相比,治疗后,研究组TNF-α及CRP水平低(P<0.05);与对照组相比,治疗后,研究组NIHSS评分、NSE水平低,BDNF水平高(P<0.05)。结论:与传统引流手术相比而言,经额锁孔入路手术治疗重型脑室出血患者效果更显著,可以有效提高血肿清除率,降低炎性介质因子水平,减轻神经缺损程度,改善脑部血流动力学,值得推广。

Objective:To investigate the effect of transfrontal keyhole approach in the treatment of severe intraventricular hemorrhage and its influence on cerebral hemodynamics.Method:A total of 92 patients with severe intraventricular hemorrhage in our hospital from June 2019 to June 2020 were selected and divided into control group(n=46)and study group(n=46)by random number method.The control group was treated with craniotomy and external ventricular drainage,and the study group was treated with transfrontal keyhole approach.The hematoma clearance rate,cerebral hemodynamics,inflammatory mediators and neurological function of the two groups were observed and analyzed.Result:Compared with the control group,the hematoma clearance rate of the study group was higher(P<0.05);compared with the control group,after treatment,the Vm and PI value of the study group were higher(P<0.05),the RI value was lower(P<0.05);compared with the control group,after treatment,the TNF-αand CRP levels of the study group were lower(P<0.05);compared with the control group,after treatment,the NIHSS score,NSE level of the study group were lower,and BDNF level was higher(P<0.05).Conclusion:Compared with the traditional drainage surgery,the effect of transfrontal keyhole approach in the treatment of patients with severe intraventricular hemorrhage is more significant,which can effectively improve the hematoma clearance rate,reduce the levels of inflammatory mediators,reduce the degree of nerve defect,and improve the cerebral hemodynamics.It is worth promoting.