立体定向血肿穿刺抽吸术联合依达拉奉对神经外科重症监护病房脑出血患者的效果观察

Effect of stereotactic hematoma puncture aspiration combined with edaravone in treatment of patients with cerebral hemorrhage in Neurosurgery Intensive Care Unit

目的探讨立体定向血肿穿刺抽吸术(SHPS)联合依达拉奉对神经外科重症监护病房(NICU)脑出血患者的影响。方法将98例NICU脑出血患者按抽签法分为实验组和对照组,每组49例。对照组采用SHPS及常规治疗,实验组在对照组基础上加用依达拉奉治疗。比较2组临床疗效、生活质量[美国国立卫生院卒中量表(NIHSS)、日常生活能力(ADL)、神经功能缺损程度量表(CSS)评分]、糖脂代谢指标[颈内静脉氧饱和度(SjvO2)、乳糖差(A-VLac)、血糖差(A-VGlu)]水平、炎性因子[白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]水平及并发症发生率。结果实验组总有效率为91.84%,高于对照组的77.55%,差异有统计学意义(P<0.05)。治疗后,实验组NIHSS评分、CSS评分低于对照组,ADL评分高于对照组,差异均有统计学意义(P<0.05)。治疗后,实验组SjvO2水平高于对照组,A-VGlu、A-VLac水平低于对照组,差异均有统计学意义(P<0.05)。治疗后,实验组IL-8、IL-6、TNF-α水平均低于对照组,差异有统计学意义(P<0.05)。实验组并发症发生率为12.24%,低于对照组的30.61%,差异有统计学意义(P<0.05)。结论SHPS联合依达拉奉能提高NICU脑出血患者的临床疗效,改善神经功能,减少术后并发症的发生。

Objective To explore the effect of stereotactic hematoma puncture aspiration(SHPS)combined with edaravone in the treatment of patients with cerebral hemorrhage in the Neurosurgery Intensive Care Unit(NICU).Methods A total of 98 patients with cerebral hemorrhage in NICU were divided into experimental group and control group by drawing lots,with 49 cases in each group.The control group was treated with SHPS and conventional therapy,while the experimental group was treated with edaravone on the basis of the control group.The clinical efficacy,the quality of life[the National Institute of Health Stroke Scale(NIHSS)score,the Ability of Daily Living(ADL)score and the China Stroke Scale(CSS)score],glucose and lipid metabolism indicators[jugular venous oxygen saturation(SjvO 2),arteriovenous lactate(A-VLac)and arteriovenous glucose(A-VGlu)],inflammatory factors[interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)]levels as well as incidence of complications were compared between the two groups.Results The total effective rate of the experimental group was 91.84%,which was significantly higher than 77.55%of the control group(P<0.05).After treatment,the NIHSS score and CSS score of the experimental group were significantly lower than those of the control group,while the ADL score was significantly higher than that of the control group(P<0.05).After treatment,the SjvO 2 level in the experimental group was significantly higher than that in the control group,while the levels of A-VGlu and A-VLac were significantly lower than those in the control group(P<0.05).After treatment,the IL-8,IL-6 and TNF-αlevels in the experimental group were significantly lower than those in the control group(P<0.05).The incidence of complications in the experimental group was 12.24%,which was significantly lower than 30.61%in the control group(P<0.05).Conclusion The combination of SHPS and edaravone can reinforce the clinical efficacy of patients with cerebral hemorrhage in NICU,improve neurological function,and reduce the incidence of postoperative complications.