微创钻孔引流术联合高压氧治疗高血压性脑出血的临床效果

Clinical effect of minimally invasive drilling and drainage combined with hyperbaric oxygen in the treatment of hypertensive intracerebral hemorrhage

目的分析微创钻孔引流术联合高压氧治疗高血压性脑出血的临床效果。方法选取我院收治的110例高血压性脑出血患者作为研究对象,根据治疗方案将其分为对照组(55例,微创钻孔引流术)和观察组(55例,微创钻孔引流术+高压氧治疗)。比较两组的治疗效果。结果观察组的苏醒时间短于对照组(P<0.05);术后2周,观察组的修订版昏迷恢复量表(CRS-R)评分高于对照组,急性生理学及慢性健康状况评价Ⅱ(APACHE-Ⅱ)及美国国立卫生研究院卒中量表(NIHSS)评分低于对照组(P<0.05)。术后1个月,观察组的神经元特异性烯醇化酶(NSE)水平低于对照组,转化生长因-β_(1)(TGF-β_(1))、脑源性神经营养因子(BDNF)水平高于对照组(P<0.05)。术后1、3个月,观察组的脑功能评分高于对照组,功能障碍评分(DFS)评分低于对照组(P<0.05)。观察组的恢复良好率和格拉斯哥预后量表(GOS)评分均高于对照组(P<0.05)。结论微创钻孔引流术联合高压氧治疗高血压性脑出血的临床效果显著,可缩短患者苏醒时间,改善NSE、TGF-β_(1)、BDNF水平及预后。

Objective To analyze the clinical effect of minimally invasive drilling and drainage combined with hyperbaric oxygen in the treatment of hypertensive intracerebral hemorrhage.Methods A total of 110 patients with hypertensive intracerebral hemorrhage admitted in our hospital were selected as the research objects and divided into control group(55 cases,minimally invasive drilling and drainage)and observation group(55 cases,minimally invasive drilling and drainage+hyperbaric oxygen treatment)according to the treatment plan.The therapeutic effects of the two groups were compared.Results The awakening time in the observation group was shorter than that in the control group(P<0.05);at 2 weeks after operation,the Coma Recovery Scale-Revised(CRS-R)score in the observation group was higher than that in the control group,the Acute Physiology and Chronic Health Evaluation-Ⅱ(APACHE-Ⅱ)and National Institute of Health Stroke Scale(NIHSS)scores were lower than those in the control group(P<0.05).One month after operation,the level of neuron-specific enolase(NSE)in the observation group was lower than that in the control group,the levels of transforming growth factor-β_(1)(TGF-β_(1))and brain-derived neurotrophic factor(BDNF)were higher than those in the control group(P<0.05).At 1 and 3 months after operation,the score of brain function in the observation group was higher than that in the control group,and the Dysfunction Score(DFS)was lower than that in the control group(P<0.05).The good recovery rate and Glasgow Outcome Scale(GOS)score in the observation group were higher than those in the control group(P<0.05).Conclusion Minimally invasive drilling and drainage combined with hyperbaric oxygen in the treatment of hypertensive intracerebral hemorrhage has a significant effect,it can shorten the awakening time of patients,improve NSE,TGF-β_(1) and BDNF levels and the prognosis.