高压氧联合神经内镜血肿清除术治疗对高血压脑出血患者炎症反应、神经功能及预后的影响

Effects of hyperbaric oxygen combined with neuroendoscopic hematoma evacuation on inflammatory response,neurological function,and prognosis in patients with hypertensive intracerebral hemorrhage

目的探讨高压氧(HBO)联合神经内镜血肿清除术治疗对高血压脑出血(HICH)患者炎症反应、神经功能及预后的影响。方法选取2019年1月至2021年12月在福建龙岩市第一医院诊治的90例HICH患者作为研究对象,按照治疗方法将患者分为观察组和对照组,每组45例。2组患者均给予神经内镜血肿清除术以及常规康复治疗,观察组在对照组的治疗基础上给予HBO治疗。比较2组患者治疗前后血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)、神经肽Y(NPY)水平、美国国立卫生研究院卒中量表(NIHSS)评分和随访6个月后的预后情况。结果治疗前,2组患者的血清TNF-α、IL-6、hs-CRP、NSE、BDNF、NPY水平和NIHSS评分比较,差异无统计学意义(P>0.05)。与治疗前比较,治疗后2组患者的血清TNF-α、IL-6、hs-CRP、NSE、NPY水平和NIHSS评分明显降低,且观察组降低更明显;血清BDNF水平明显升高,且观察组升高更明显,差异有统计学意义(P<0.05)。2组患者均未发生死亡。观察组患者预后恢复优于对照组,差异有统计学意义(P<0.05)。结论HBO联合神经内镜血肿清除术治疗HICH患者,可有效减轻患者的炎症反应,改善脑组织损伤程度、神经功能和预后。

Objective To investigate the effect of hyperbaric oxygen(HBO)combined with neuroendoscopic hematoma evacuation on inflammatory response,neurological function,and prognosis in patients with hypertensive intracerebral hemorrhage(HICH).Methods A total of 90 patients with HICH who were diagnosed and treated in the Longyan First Hospital of Fujian province from January 2019 to December 2021 were selected as the research objects.According to the treatment methods,the patients were divided into observation group and control group,with 45 cases in each group.Both groups were given neuroendoscopic hematoma evacuation and conventional rehabilitation treatment,and the observation group was given HBO treatment on the basis of the treatment of the control group.The levels of serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP),neuron-specific enolase(NSE),brain-derived neurotrophic factor(BDNF),neuropeptide Y(NPY),National Institutes of Health Stroke Scale(NIHSS)scores,and prognoses after six months of follow-up were compared between the two groups before and after treatment.Results Before treatment,there was no significant difference being found in the comparison of the serum levels of TNF-α,IL-6,hs-CRP,NSE,BDNF,NPY,and NIHSS score between the two groups,with no statistically significant difference(P>0.05).Compared with those before treatment,the levels of serum TNF-α,IL-6,hs-CRP,NSE,NPY,and NIHSS scores in the two groups significantly decreased after treatment,and the decreases in the observation group were more obvious;the level of serum BDNF significantly increased,and the increase in the observation group was more obvious,the differences were statistically significant(P<0.05).No death occurred in the two groups.The prognosis of the observation group was better than that of the control group,and the difference was statistically significant(P<0.05).Conclusion HBO combined with neuroendoscopic hematoma evacuation can effectively alleviate the inflammatory response,improve the degree of brain tissue damage,neurological function,and prognosis of patients with HICH.