双管软通道引流术与显微镜下小骨窗开颅术治疗大血肿量高血压脑出血的效果及对炎症指标、氧化应激的影响

Effect of Double Hose Channel Drainage and Small Bone Window Craniotomy under Microscope in the Treatment of Hypertensive Cerebral Hemorrhage with Large Hematoma Volume and Its Influence on Inflammatory Indexes and Oxidative Stress

目的:探讨并分析双软管通道引流术与显微镜下小骨窗开颅术治疗大血肿量高血压脑出血(HICH)的效果及对炎症指标、氧化应激的影响。方法:选取2020年1月—2022年12月在赣南医学院第三附属医院治疗的HICH患者136例,随机分为对照组(n=68)和试验组(n=68)。对照组采用显微镜下小骨窗开颅术治疗,试验组采用双管软通道引流术治疗。比较两组临床疗效、炎症指标[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]、氧化应激[脂质过氧化(LPO)、谷胱甘肽过氧化物酶(GSH-Px)和丙二醛(MDA)]、术后并发症发生率。结果:两组临床疗效比较,差异无统计学意义(P>0.05);术后1周,两组hs-CRP、TNF-α、IL-6水平均较术前显著降低,且试验组均低于对照组,差异均有统计学意义(P<0.05);术后1周,两组LPO、MDA均较术前显著降低,试验组LPO、MDA均低于对照组,GSH-Px均较术前显著升高,试验组GSH-Px高于对照组,差异均有统计学意义(P<0.05);试验组术后并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。结论:双管软通道引流术与显微镜下小骨窗开颅术治疗HICH均有较好的效果,但双管软通道引流术可降低术后并发症发生率,且其术后炎症反应更轻、应激反应更小。

Objective:To investigate and analyze the effect of double hose channel drainage and small bone window craniotomy under microscope in the treatment of hypertensive cerebral hemorrhage(HICH)with large hematoma volume and its influence on inflammatory indexes and oxidative stress.Method:A total of 136 patients with HICH treated in the Third Affiliated Hospital of Gannan Medical College from January 2020 to December 2022 were selected and randomly divided into control group(n=68)and experimental group(n=68).The control group was treated with small bone window craniotomy under microscope,and the experimental group was treated with double hose channel drainage.The clinical efficacy,inflammatory indexes[hypersensitive C reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],oxidative stress[lipid peroxide(LPO),glutathione peroxidase(GSH-Px)and malondialdehyde(MDA)]and incidence of postoperative complications were compared between the two groups.Result:There was no significant difference in clinical efficacy between the two groups(P>0.05).1 week after surgery,the levels of hs-CRP,TNF-αand IL-6 in the two groups were significantly lower than those before surgery,and those in the experimental group were lower than those in the control group,the differences were statistically significant(P<0.05).1 week after surgery,LPO and MDA in both groups were significantly decreased compared with those before surgery,LPO and MDA in experimental group were lower than those in control group,GSH-Px were significantly increased compared with those before surgery,GSH-Px in experimental group was higher than that in control group,the differences were statistically significant(P<0.05).The incidence of postoperative complications in experimental group was significantly lower than that in control group,the difference was statistically significant(P<0.05).Conclusion:Both double hose channel drainage and small bone window craniotomy under microscope have good effects in the treatment of HICH,but double hose channel drainage can reduce the incidence of postoperative complications,and the postoperative inflammatory reaction and stress reaction are lighter.