微创手术和开颅手术在脑出血治疗中的效果和安全性评价

Evaluation of the Efficacy and Safety of Minimally Invasive Surgery and Craniotomy in the Treatment of Cerebral Hemorrhage

目的 探讨脑出血患者采用微创手术与开颅手术的应用效果。方法 选取2020年1月—2022年12月湘乡市人民医院80例脑出血患者作为研究对象。依据随机数字表法分组,各40例。对照组采用开颅手术,观察组采用微创手术。对比2组临床指标、脑源性神经营养因子(brain derived neurotrophic factor,BDNF)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)指标、白细胞介素-1β(interleukin-1β,IL-1β)、血小板反应蛋白2(thrombospondin2,TSP2)及并发症发生率。结果 观察组手术时间、住院时间短于对照组,术中出血量少于对照组,手术切口短于对照组,差异有统计学意义(P<0.05);术后,观察组BDNF指标高于对照组,MMP-9指标低于对照组,差异有统计学意义(P<0.05);术后,观察组IL-1β、TSP2指标低于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率为5.00%,低于对照组的20.00%,差异有统计学意义(P<0.05)。结论 对脑出血患者手术时,微创手术可改善BDNF、MMP-9水平,减少术后并发症,恢复神经功能。

Objective To explore the application effect of minimally invasive surgery and craniotomy in patients with cerebral hemorrhage.Methods A total of 80 patients with cerebral hemorrhage in the People's Hospital of Xiangxiang from January 2020 to December 2022 were selected as the study objects.According to random number table method,each group was 40 cases.The control group underwent craniotomy and the observation group underwent minimally invasive surgery.The clinical indexes,brain derived neurotrophic factor(BDNF),matrix metalloproteinase-9(MMP-9),interleukin-1β(IL-1β),thrombospondin2(TSP2)and complication rate of the two groups were compared.Results The operation time and hospital stay in the observation group were shorter than those in the control group,the amount of intraoperative blood loss and surgical incision were shorter than those in the control group,and the differences were statistically significant(P<0.05).After surgery,the BDNF index in the observation group was higher than that in the control group,and the MMP-9 index was lower than that in the control group,the differences were statistically significant(P<0.05).After operation,IL-1βand TSP2 indexes in observation group were lower than those in control group,and the difference was statistically significant(P<0.05).The total incidence of complications in the observation group was 5.00%,lower than that in the control group(20.00%),the difference was statistically significant(P<0.05).Conclusion Minimally invasive surgery can significantly improve BDNF and MMP-9 levels,reduce postoperative complications,and restore neurological function in patients with cerebral hemorrhage during surgery.