开颅血肿清除术联合颞浅动脉贴覆术治疗高血压脑出血的效果

Effect of craniotomy hematoma evacuation combined with encephalo-superficial temporal artery-synangiosis on hypertensive cerebral hemorrhage

目的探讨开颅血肿清除术联合颞浅动脉贴覆术治疗高血压脑出血的效果。方法选取2019年4月至2021年4月我院收治的120例高血压脑出血患者作为研究对象,按照治疗方法不同将其分为对照组和研究组,各60例。对照组实施开颅血肿清除术,研究组实施开颅血肿清除术联合颞浅动脉贴覆术。比较两组的神经功能损伤指标、神经递质水平、创伤应激指标及并发症发生情况。结果术后2周,两组的神经元特异性烯醇化酶(NSE)、S100B蛋白、谷氨酸(Glu)及天冬氨酸(Asp)水平降低,甘氨酸(Gly)水平升高,且研究组优于对照组(P<0.05)。术后3 d,研究组的前列腺素E_(2)(PGE_(2))、高迁移率族蛋白-1(HMGB-1)水平低于对照组,谷胱甘肽过氧化物酶(GSH-PX)水平高于对照组(P<0.05)。研究组的并发症总发生率低于对照组(P<0.05)。结论开颅血肿清除术联合颞浅动脉贴覆术治疗高血压脑出血的效果较好,可减轻神经功能损伤及创伤应激反应,减少并发症,具有较高的临床推广意义。

Objective To explore the effect of craniotomy hematoma evacuation combined with encephalo-superficial temporal artery-synangiosis on hypertensive cerebral hemorrhage.Methods A total of 120 patients with hypertensive cerebral hemorrhage admitted in our hospital from April 2019 to April 2021 were selected as the research objects,and the patients were divided into control group and study group according to different treatment schemes,with 60 cases in each group.The control group implemented craniotomy hematoma evacuation,and the study group implemented craniotomy hematoma evacuation combined with encephalo-superficial temporal artery-synangiosis.The neurological impairment indexes,neurotransmitter levels,traumatic stress indexes and occurrence of complications were compared between the two groups.Results After 2 weeks of surgery,the levels of neuron-specific enolase(NSE),S100B protein,glutamate(Glu)and asparaginic acid(Asp)of the two groups decreased,the level of glycine(Gly)increased,and those of the study group were better than the control group(P<0.05).After 3 d of surgery,the prostaglandin E_(2)(PGE_(2))and high mobility group box-1(HMGB-1)levels in the study group were lower than those in the control group,and the level of glutathione peroxidase(GSH-PX)was higher than that in the control group(P<0.05).The total incidence of complications in the study group was lower than that in the control group(P<0.05).Conclusion Craniotomy hematoma evacuation combined with encephalo-superficial temporal artery-synangiosis in the treatment of hypertensive cerebral hemorrhage has a good effect,which can relieve neurological impairment and traumatic stress reaction,reduce complications,and has higher clinical promotion significance.