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超早期小骨窗开颅手术在高血压脑出血患者中的应用效果及对血流动力学的影响

Application Effect of Super-early Small Bone Window Craniotomy in Patients with Hypertensive Cerebral Hemorrhage and Its Influence on Hemodynamics
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摘要 目的:探讨超早期小骨窗开颅手术在高血压脑出血患者中的应用效果及对血流动力学的影响。方法:选取2020年1月—2022年3月泰兴市人民医院收治的92例高血压脑出血患者作为研究对象,依据随机数表法将患者分为对照组(46例)、观察组(46例)。对照组给予早期大骨窗开颅手术,观察组给予超早期小骨窗开颅手术,两组均随访1个月。比较两组临床疗效、手术时间、术中出血量、意识恢复时间,比较两组术前与术后7 d收缩压(SBP)、心率(HR)、舒张压(DBP)、平均动脉压(MAP)及血清脑源性神经营养因子(BDNF)、神经生长因子(NGF)、神经元特异性烯醇化酶(NSE)、神经肽Y(NPY)水平,比较两组并发症发生情况。结果:观察组总有效率为95.65%,高于对照组的63.04%,差异有统计学意义(P<0.05);观察组手术时间、意识恢复时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);术后7 d,两组血清BDNF水平较术前升高,且观察组高于对照组,两组SBP、HR、DBP、MAP及血清NSE、NGF、NPY水平较术前均降低,且观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为6.52%,低于对照组的26.09%,差异有统计学意义(P<0.05)。结论:高血压脑出血患者应用超早期小骨窗开颅手术可有效提高临床治疗效果,并缩短手术时间,减少出血量,促进患者病情恢复,改善血流动力学指标,减轻神经功能损伤程度,减少并发症发生。 Objective:To investigate the application effect of super-early small bone window craniotomy in patients with hypertensive cerebral hemorrhage and its influence on hemodynamics.Method:A total of 92 patients with hypertensive cerebral hemorrhage who admitted to Taixing People's Hospital from January 2020 to March 2022 were selected as the research objects,the patients were divided into the control group(46 cases)and the observation group(46 cases)according to the random number table method.The control group was treated with early large bone window craniotomy,and the observation group was treated with super-early small bone window craniotomy,two groups were followed up for 1 month.The clinical efficacy,operation time,intraoperative blood loss and consciousness recovery time were compared between two groups,the levels of systolic blood pressure(SBP),heart rate(HR),diastolic blood pressure(DBP),mean arterial pressure(MAP),serum brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF),neuron-specific enolase(NSE)and neuropeptide Y(NPY)were compared between two groups before and 7 d after operation,the incidence of complications were compared between two groups.Result:The total effective rate of the observation group was 95.65%,which was higher than 63.04%of the control group,the difference was statistically significant(P<0.05);the operation time and consciousness recovery time in the observation group were shorter than those in the control group,and the intraoperative blood loss in the observation group was less than that in the control group,the differences were statistically significant(P<0.05);at 7 d after operation,the levels of serum BDNF in two groups were higher than those before operation,and that in the observation group was higher than that in the control group,the levels of SBP,HR,DBP,MAP and serum NSE,NGF and NPY in two groups were lower than those before operation,and those in the observation group were lower than the control group,the differences were statistically significant(P<0.05);the incidence of complications in the observation group was 6.52%,which was lower than 26.09%in the control group,the difference was statistically significant(P<0.05).Conclusion:The application of super-early small bone window craniotomy in patients with hypertensive cerebral hemorrhage can effectively improve the clinical treatment effect,shorten the operation time,reduce the amount of bleeding,promote the recovery of patient's condition,improve the hemodynamic index,reduce the degree of neurological damage,and reduce the occurrence of complications.
作者 印辰宇 YIN Chenyu(Taixing People's Hospital,Taixing 225400,China)
机构地区 泰兴市人民医院
出处 《中外医学研究》 2023年第32期31-34,共4页 CHINESE AND FOREIGN MEDICAL RESEARCH
关键词 高血压脑出血 超早期小骨窗开颅手术 应用效果 血流动力学 Hypertensive cerebral hemorrhage Super-early small bone window craniotomy Application effect Hemodynamics
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