CT三维重建引导下微创软通道穿刺引流术对脑出血治疗效果

The therapeutic effect of different minimally invasive soft channel puncture and drainage techniques on patients with cerebral hemorrhage

目的不同微创软通道穿刺引流术对脑出血患者治疗效果。方法回顾性选取2022年10月至2023年10月南阳市中心医院收治的117例脑出血患者,根据不同的治疗方式分为接受传统微创软通道穿刺引流术治疗的对照组(56例),以及接受CT三维重建引导下微创软通道穿刺引流术治疗的试验组(61例)。比较2组患者手术相关指标(手术时间、插管一次性成功率、12 h脑内血肿清除率、术后住院时间),血清脑原性神经营养因子(BDNF)、水通道蛋白4(AQP4)水平,神经功能缺损程度及术后并发症发生情况。结果2组脑内血肿清除率差异无统计学意义(P>0.05),但试验组插管一次性成功率显著高于对照组,手术时间、术后住院时间显著短于对照组(P<0.05);术后14 d,试验组血清BDNF水平显著高于对照组,血清AQP4水平显著低于对照组(P<0.05);术后6个月,试验组美国国立卫生研究院卒中量表(NIHSS)评分显著低于对照组(P<0.05);术后试验组并发症总发生率显著低于对照组(P<0.05)。结论CT三维重建引导下微创软通道穿刺引流术治疗脑出血效果血肿清除率与常规微创穿刺引流术相当,且其能有效缩短手术时间、住院时间,提高插管成功率,对神经功能损伤小,能有效调节血清BDNF、AQP4水平,术后并发症少,安全可靠。

Objective To observe the therapeutic effect of different minimally invasive soft channel puncture and drainage on patients with cerebral hemorrhage.Methods A retrospective selection was conducted on 117 patients with cerebral hemorrhage admitted to Nanyang Central Hospital from October 2022 to October 2023.According to different treatment methods,they were divided into control group(n=56)who received traditional minimally invasive soft channel puncture and drainage surgery,and experimental group(n=61)who received minimally invasive soft channel puncture and drainage surgery guided by CT three-dimensional reconstruction.Surgical related indicators(surgical time,one-time success rate of intubation,12 h intracerebral hematoma clearance rate,postoperative hospital stay),serum brain-derived neurotrophic factor(BDNF)and aquaporin-4(AQP4)levels,degree of neurological deficits,and incidence of postoperative complications were compared.Results There was no significant difference in the clearance rate of intracerebral hematoma between the two groups(P>0.05),but the one-time success rate of intubation in experimental group was significantly higher than that in control group,the surgical time and postoperative hospital stay were significantly shorter than those in control group(P<0.05);14 days after surgery,the serum BDNF level in experimental group was significantly higher than that in control group,and the serum AQP4 level was significantly lower than that in control group(P<0.05);Six months after surgery,the National Institutes of Health Stroke Scale(NIHSS)score in experimental group was significantly lower than that in control group(P<0.05);The total incidence of postoperative complications in experimental group was significantly lower than that in control group(P<0.05).Conclusion CT three-dimensional reconstruction guided minimally invasive soft channel puncture and drainage for the treatment of cerebral hemorrhage has a hematoma clearance rate comparable to conventional minimally invasive puncture and drainage,and it can effectively shorten surgical time,hospital stay,improve intubation success rate,cause minimal damage to neurological function,and effectively regulate serum BDNF AQP4 level,have less postoperative complications,be safe and reliable.