CT引导的神经内镜术与硬通道穿刺术治疗高血压脑出血的效果及对神经功能指标、脑血流参数的影响

Effect of CT guided neuroendoscopy and hard channel puncture in the treatment of hypertensive intracerebral hemorrhage and its influence on neurological indexes and cerebral blood flow parameters

目的探讨CT引导的神经内镜术与硬通道穿刺术治疗高血压脑出血的效果及对神经功能指标、脑血流参数的影响。方法选取2017年1月至2019年12月在西安高新医院就诊的118例高血压脑出血患者,根据随机数字表法将其分为对照组(59例,CT引导的硬通道穿刺术)和观察组(59例,CT引导的神经内镜术)。比较两组的治疗效果、神经功能指标及脑血流参数。结果观察组的治疗总有效率为86.44%,明显高于对照组的69.49%(P<0.05)。治疗后,两组的神经元特异性烯醇化酶(NSE)、神经肽Y(NPY)水平均降低,脑源性神经营养因子(BDNF)水平均升高,且观察组明显优于对照组(P<0.05)。治疗后,两组的外周阻力(R)均减小,平均血流量(Q)、平均血流速度(V)均增大,且观察组明显优于对照组(P<0.05)。结论在CT引导下,神经内镜术治疗高血压脑出血的效果优于硬通道穿刺术,其血肿清除率更高,但手术操作比较复杂,临床上可根据实际情况选取合适的手术方式进行治疗。

Objective To explore the effect of CT guided neuroendoscopy and hard channel puncture in the treatment of hypertensive intracerebral hemorrhage and its influence on neurological indexes and cerebral blood flow parameters.Methods A total of 118 patients with hypertensive intracerebral hemorrhage admitted in Xi'an Gaoxin hospital from January 2017 to December 2019 were selected and divided into control group(59 cases,CT guided hard channel puncture)and observation group(59 cases,CT guided neuroendoscopy)according to random number table method.The therapeutic effects,neurological indexes and cerebral blood flow parameters were compared between the two groups.Results The total effective rate of treatment in the observation group was 86.44%,which was significantly higher than 69.49%in the control group(P<0.05).After treatment,the levels of neuron specific enolase(NSE)and neuropeptide Y(NPY)in the two groups decreased,and the level of brain derived neurotrophic factor(BDNF)increased,and those in the observation group were significantly better than the control group(P<0.05).After treatment,the peripheral resistance(R)in the two groups decreased,the average blood flow(Q)and average blood flow velocity(V)increased,and those in the observation group were significantly better than the control group(P<0.05).Conclusion Under CT guidance,the effect of neuroendoscopy in the treatment of hypertensive intracerebral hemorrhage is better than hard channel puncture,and its hematoma clearance rate is higher,but the operation is more complex.Clinically,an appropriate operation method can be selected according to the actual situation.