比较CT立体定位引导穿刺清除术和常规穿刺清除术对脑出血患者内皮素表达水平、GOS评分、SF-36评分及颅内感染发生率影响

Comparison of CT-guided Stereotactic Puncture Evacuation and Conventional Puncture Evacuation on Endothelin,GOS,SF-36 and Intracranial Infections in Patients with Cerebral Haemorrhage

目的探究比较CT立体定位引导穿刺清除术和常规穿刺清除术对脑出血患者内皮素表达水平、GOS评分、SF-36评分及颅内感染发生率影响。方法选取我院2019年5月~2021年5月脑病科收治的178例脑出血患者为研究对象,采用随机分组法分为观察组与对照组,两组各89例。对照组采用常规穿刺清除术,观察组采用CT立体定位引导穿刺清除术。观察两组患者治疗前后血清内皮功能情况、GOS评分、NIHSS评分及SF-36评分。观察两组患者手术一般情况与不良反应发生率。结果两组患者术前NO、ET-1水平无统计学差异(P>0.05)。术后两组患者NO水平无统计学差异(P>0.05),但术后观察组ET-1水平较对照组显著降低(P<0.05)。两组患者治疗前生理功能、社会功能、角色限制、活力、情感职能、精神健康、身体疼痛、总体健康无统计学差异(P>0.05)。治疗后观察组生理功能、社会功能、角色限制、活力、情感职能、精神健康、身体疼痛、总体健康评分显著高于对照组(P<0.05)。观察组穿刺时间、穿刺成功所用次数、引流管脑室走行长度及引流时间均显著低于对照组(P<0.05)。观察组总不良反应发生率为3.36%略低于对照组5.60%,但两组患者总不良反应发生率无统计学差异(χ^(2)=0.523,P=0.469)。结论CT立体定位引导穿刺清除术较常规穿刺清除术操作简便,能有效降低患者内皮素水平、提高患者生活质量,降低神经功能损伤。

Objective To compare the effect of computerized tomography(CT)-guided stereotactic puncture evacuation and conventional puncture evacuation on endothelin-1(ET-1),Glasgow Outcome Scale(GOS),MOS-36-item short-from health survey(SF-36)and intracranial infections in patients with cerebral haemorrhage.Methods A sample of 178 patients with cerebral haemorrhage in Encephalopathy Division of our hospital from May 2019 to May 2021 were enrolled,and randomly classified into two groups,each with 89 cases.Control group received conventional puncture evacuation,while observation group received CT-guided stereotactic puncture evacuation.Then comparison was conducted on endothelial function,GOS score,National Institutes of Health Stroke Scale(NIHSS),SF-36,operation indexes and adverse reactions.Results Serum levels of nitric oxide(NO)and ET-1 yielded no statistical difference between two groups before treatment(P>0.05).Postoperative NO level of two groups had no statistical difference(P>0.05),while ET-1 level was remarkably decreased in observation group compared with control group(P<0.05).Scores of physical functioning(PF),social functioning(SF),role-physical(RP),vitality(VT),role-emotional(RE),mental-health(MH),bodily pain(BP),and general health(GH)demonstrated no statistical difference between two groups(P>0.05),while observation group scored higher on SF-36 than control group after treatment(P<0.05).Puncture time,times of successful puncture,ventricle length and drainage time were better in observation group than in control group(P<0.05).The adverse reaction rate was 3.36% in observation group,which was slightly lower than 5.60% in control group,with no statistical difference(χ^(2)=0.523,P=0.469).Conclusion Compared with conventional puncture evacuation,application of CT-guided stereotactic puncture evacuation for cerebral haemorrhage is better in tersm of easier surgical procedures,reduction of endothelin,improvement of quality of life and alleviation of neurological deficits in patients.