Objective:To study the effect of minimally invasive intracranial hematoma drainage on inflammatory factors, serum ferritin and serum P substance in patients with hypertensive cerebral hemorrhage.Methods:92 cases of hy...Objective:To study the effect of minimally invasive intracranial hematoma drainage on inflammatory factors, serum ferritin and serum P substance in patients with hypertensive cerebral hemorrhage.Methods:92 cases of hypertensive cerebral hemorrhage patients in our hospital were selected and randomly divided into 2 groups: minimally invasive group (51 cases) and routine group (41 cases). Minimally invasive intracranial hematoma drainage was performed on the minimally invasive group. Bone flap decompression or small bone window craniotomy were used in the routine group. Tumor necrosis factorα (TNF-α), interleukin-6 (IL-6), high sensitive C reactive protein (hs-CRP) and serum protein (SF), serum substance P (SP) in the 2 groups were detected before treatment and 2 weeks after treatment.Results: The comparison of TNF-α, IL-6, hs-CRP, SP, and SF in the two groups before treatment was not statistically significant (P>0.05). TNF-α, IL-6, hs-CRP and SF in both groups after treatment significantly decreased, compared with that before treatment (P<0.01,P<0.05). TNF-α, IL-6, and SF in minimally invasive group decreased more significantly than that in routine group (P<0.01);The comparison of SP in the two groups after treatment significantly increased compared with that before treatment (P<0.01,P<0.05). SP in minimally invasive group increased more significantly than that in routine group (P<0.05).Conclusions:Compared with bone flap decompression or small bone window craniotomy, minimally invasive intracranial hematoma drainage can inhibit inflammatory reaction, reduce the degree of nerve damage and alleviate clinical symptoms more effectively.展开更多
Objective:To investigate the effects of minimally invasive craniotomy combined with edaravone on cerebral oxygen metabolism, cerebrovascular function and oxidative stress in patients with acute cerebral hemorrhage.Met...Objective:To investigate the effects of minimally invasive craniotomy combined with edaravone on cerebral oxygen metabolism, cerebrovascular function and oxidative stress in patients with acute cerebral hemorrhage.Methods:A total of 100 patients with acute cerebral hemorrhage treated in our hospital from March 2015 to February 2017 were randomly divided into control group and observation group. 50 patients in the control group were treated with minimally invasive craniotomy. On the basis of control group, patients in the observation group were treated with edaravone. Cerebral oxygen metabolism, cerebrovascular function and oxidative stress were measured later in both groups.Results:After treatment, the levels of SOD in both groups increased significantly and MDA levels decreased significantly, and SOD level in the observation group was (97.34±1.95) U/mL, which was significantly higher than the control group, MDA level was (2.77±0.11) mol/L and significantly lower than that of the control group after treatment;After treatment, the levels of ET in both groups were significantly lower than those before treatment, and the levels of CGRP were significantly higher than those before treatment. ET level in observation group was (3.24±0.22) μg/L after treatment, which was significantly lower than that in control group (59.67±0.79) pg/mL, which was significantly higher than the control group;After treatment, the levels of SjvO2, CjvO2 and PbtO2 in both groups were significantly increased compared with before treatment, the levels of Da-jvO2 and CEO2 were significantly lower than the level of before treatment, and the levels of SjvO2, The levels of CjvO2 and PbtO2 were (62.93±1.63)%, (99.31±0.94) mL/L and (28.56±1.55) mmHg, which were significantly higher than the control group. Da-jvO2 and CEO2 levels were (51.31±1.13) mL/L and (30.52±0.43)%, which were significantly lower than the control group.Conclusion: Edaravone combined with minimally invasive craniotomy can effectively reduce the level of oxidative stress, improve endothelial function and cerebral oxygen metabolism, and has reliable curative effect. It is worth further clinical application.展开更多
Objective:To study the effect of minimally invasive evacuation of hematoma combined with Xingnaojing therapy on neurological function damage and cytokine level in patients with hypertensive cerebral hemorrhage.Methods...Objective:To study the effect of minimally invasive evacuation of hematoma combined with Xingnaojing therapy on neurological function damage and cytokine level in patients with hypertensive cerebral hemorrhage.Methods:A total of 80 patients with hypertensive cerebral hemorrhage treated in our hospital between June 2010 and September 2015 were selected as the research subjects, the treatment methods and test results were reviewed, and then they were divided into the control group (n=45) who accepted minimally invasive evacuation of hematoma alone and the observation group (n=35) who accepted minimally invasive evacuation of hematoma combined with Xingnaojing therapy. Before and after treatment, cerebral blood flow detector was used to detect cerebral blood flow parameters;ELISA method was used to detect serum levels of neurological function indexes and inflammatory cytokines;high performance liquid chromatograph was used to detect serum neurotransmitter levels. Results: Before treatment, the differences in cerebral blood flow parameters, neurological function indexes, inflammatory cytokines and neurotransmitters were not statistically significant between two groups of patients. After treatment, cerebral blood flow parameters Q and V levels of observation group were higher than those of control group while R level was lower than that of control group;serum NSE, NPY, IL-1β, IL-4, IL-6, TNF-α, Glu and Asp contents of observation group were lower than those of control group while BDNF and Gly contents were higher than those of control group.Conclusion: Minimally invasive evacuation of hematoma combined with Xingnaojing therapy can improve the neurological function and regulate the synthesis of inflammatory cytokines and neurotransmitters in patients with hypertension cerebral hemorrhage.展开更多
Objective:To explore the therapeutic effect of minimally invasive intracranial hematoma evacuation in the treatment of hypertensive cerebral hemorrhage and the value of dynamic TCD monitoring in predicting the neurolo...Objective:To explore the therapeutic effect of minimally invasive intracranial hematoma evacuation in the treatment of hypertensive cerebral hemorrhage and the value of dynamic TCD monitoring in predicting the neurological function recovery.Methods: A total of 70 patients with hypertensive cerebral hemorrhage who were admitted in our hospital were included in the study and divided into the minimally invasive group and conservative group with 35 cases in each group according to different treatment protocols. The patients in the two groups were given drug conservative treatments. On this basis, the patients in the minimally invasive group were given urokinase in combined with minimally invasive hematoma puncture with YL-1 type needle. TCD was performed before treatment, 1 d, 5 d, 10 d, and 21 d after treatment. The hematoma and edema volume was calculated. NIHSS was used to evaluate the neurological function recovery.Results: Vs, Vd, and Vm after treatment in the minimally invasive group were significantly elevated, while PI was significantly reduced. Vs, Vd, and Vm after treatment in the conservative group were reduced first and elevated later, while PI was elevated first and reduced later, and reached the lowest/peak 10d after treatment. Vs, Vd, and Vm 5 d, 10 d, and 21 d after treatment in the minimally invasive group were significantly higher than those in the conservative group, while PI was significantly lower than that in the conservative group. The hematoma and edema volume after treatment in the two groups was significantly reduced. The hematoma and edema volume at each timing point was significantly lower than that in the conservative group. NIHSS score after treatment in the minimally invasive group was significantly reduced. NIHSS score in the conservative group was elevated first and reduced later, reached the peak 10d after treatment, and at each timing point was higher than that in the minimally invasive group.Conclusions:The early minimally invasive operation can significantly improve the hematoma adjacent blood flow volume in patients with hypertensive cerebral hemorrhage, and contribute to the neurological function recovery. TCD not only can be applied in the dynamic monitoring of cerebral blood flow volume in patients with hypertensive cerebral hemorrhage, but also has a certain value in evaluating the prognosis of neurological function.展开更多
Objective:To observe the clinical efficacy of urokinase in combined with minimally invasive hematoma puncture with YL-1 type needle in the treatment of hypertensive cerebral hemorrhage and the effect on blood sugar an...Objective:To observe the clinical efficacy of urokinase in combined with minimally invasive hematoma puncture with YL-1 type needle in the treatment of hypertensive cerebral hemorrhage and the effect on blood sugar and serum CRP.Methods:A total of 84 patients with hypertensive cerebral hemorrhage who were admitted in our hospital were included in the study and divided into the minimally invasive group (n=53) and the conservative group (n=31) according to different treatment protocols. The patients in the two groups were given routine drug treatments. The patients in the observation group were given urokinase in combined with minimally invasive hematoma puncture with YL-1 type needle. The blood sugar and serum CRP levels before and after treatment in the two groups were compared. CT was performed to reexamine the cerebral hematoma and edema volume.Results: The serum CRP and blood sugar levels 3, 7 and 14 d after treatment in the minimally invasive group were significantly lower than those in the conservative group (P<0.05). The cerebral hematoma and edema volume 1, 3, 7, and 14 d after treatment in the minimally invasive group was significantly lower than that in the conservative group (P<0.05).Conclusions: Urokinase in combined with minimally invasive hematoma puncture with YL-1 type needle in the treatment of hypertensive cerebral hemorrhage can significantly alleviate the brain tissue injury, reduce the systemic inflammatory reaction and blood sugar level, and contribute to the rehabilitation.展开更多
目的:系统评价颅内血肿微创清除手术联合脑血疏口服液治疗自发性脑出血的疗效及安全性。方法:计算机检索从建库至2023年6月收录于中国期刊全文数据库(China National Knowledge Infrastructure,CNKI)、维普中文科技期刊数据库(VIP Chine...目的:系统评价颅内血肿微创清除手术联合脑血疏口服液治疗自发性脑出血的疗效及安全性。方法:计算机检索从建库至2023年6月收录于中国期刊全文数据库(China National Knowledge Infrastructure,CNKI)、维普中文科技期刊数据库(VIP Chinese science and technology journal database,VIP)、万方数据库、中国生物医学文献数据库(The Chinese biomedical literature database,CBM)、PubMed、Embase、the Cochrane Library等中英文数据库,结合纳入与排除标准筛选出所有颅内血肿微创清除手术联合脑血疏口服液治疗自发性脑出血的临床随机对照试验,根据Cochrane系统评价手册对纳入研究进行偏倚风险评价,运用Revman5.4软件进行Meta分析,最后采用GRADE系统对结局指标进行证据质量评价。结果:共纳入9项研究,总样本量739例。其中,对照组371例,试验组368例。Meta分析结果显示,与血肿微创清除后仅予常规西医治疗相比,联合应用脑血疏口服液能够提高自发性脑出血患者临床治疗的总有效率[OR=5.47,95%CI=2.28,13.09,P=0.0001],在降低患者美国国立卫生研究所卒中量表评分[MD=−3.42,95%CI=−4.97,−1.87,P<0.0001]和中国脑卒中患者神经功能缺损程度评分[MD=−2.30,95%CI=−3.01,−1.58,P<0.00001],提高患者格拉斯哥昏迷量表(Glasgow coma scale,GCS)评分[MD=1.51,95%CI=1.13,1.89,P<0.00001]和Barthel指数(Barthel index,BI)评分[MD=6.88,95%CI=4.49,9.27,P<0.00001],降低血清S100蛋白[MD=−0.02,95%CI=−0.03,−0.02,P<0.00001]和水通道蛋白4水平[MD=−0.02,95%CI=−0.03,−0.01,P=0.002]方面均具有明显优势。安全性方面,所纳研究均无严重不良反应;2项研究报告有恶心、腹胀、腹泻的胃肠道不适症状,其余研究未报告不良反应发生。结论:现有证据表明,颅内血肿微创清除手术联合脑血疏口服液治疗自发性脑出血疗效确切,能够明显减轻患者神经功能缺损和意识障碍程度,提高患者日常生活能力,改善患者生活质量,且具有一定的安全性。展开更多
文摘Objective:To study the effect of minimally invasive intracranial hematoma drainage on inflammatory factors, serum ferritin and serum P substance in patients with hypertensive cerebral hemorrhage.Methods:92 cases of hypertensive cerebral hemorrhage patients in our hospital were selected and randomly divided into 2 groups: minimally invasive group (51 cases) and routine group (41 cases). Minimally invasive intracranial hematoma drainage was performed on the minimally invasive group. Bone flap decompression or small bone window craniotomy were used in the routine group. Tumor necrosis factorα (TNF-α), interleukin-6 (IL-6), high sensitive C reactive protein (hs-CRP) and serum protein (SF), serum substance P (SP) in the 2 groups were detected before treatment and 2 weeks after treatment.Results: The comparison of TNF-α, IL-6, hs-CRP, SP, and SF in the two groups before treatment was not statistically significant (P>0.05). TNF-α, IL-6, hs-CRP and SF in both groups after treatment significantly decreased, compared with that before treatment (P<0.01,P<0.05). TNF-α, IL-6, and SF in minimally invasive group decreased more significantly than that in routine group (P<0.01);The comparison of SP in the two groups after treatment significantly increased compared with that before treatment (P<0.01,P<0.05). SP in minimally invasive group increased more significantly than that in routine group (P<0.05).Conclusions:Compared with bone flap decompression or small bone window craniotomy, minimally invasive intracranial hematoma drainage can inhibit inflammatory reaction, reduce the degree of nerve damage and alleviate clinical symptoms more effectively.
基金This study was supported by National Natural Science Foundation(81371345).
文摘Objective:To investigate the effects of minimally invasive craniotomy combined with edaravone on cerebral oxygen metabolism, cerebrovascular function and oxidative stress in patients with acute cerebral hemorrhage.Methods:A total of 100 patients with acute cerebral hemorrhage treated in our hospital from March 2015 to February 2017 were randomly divided into control group and observation group. 50 patients in the control group were treated with minimally invasive craniotomy. On the basis of control group, patients in the observation group were treated with edaravone. Cerebral oxygen metabolism, cerebrovascular function and oxidative stress were measured later in both groups.Results:After treatment, the levels of SOD in both groups increased significantly and MDA levels decreased significantly, and SOD level in the observation group was (97.34±1.95) U/mL, which was significantly higher than the control group, MDA level was (2.77±0.11) mol/L and significantly lower than that of the control group after treatment;After treatment, the levels of ET in both groups were significantly lower than those before treatment, and the levels of CGRP were significantly higher than those before treatment. ET level in observation group was (3.24±0.22) μg/L after treatment, which was significantly lower than that in control group (59.67±0.79) pg/mL, which was significantly higher than the control group;After treatment, the levels of SjvO2, CjvO2 and PbtO2 in both groups were significantly increased compared with before treatment, the levels of Da-jvO2 and CEO2 were significantly lower than the level of before treatment, and the levels of SjvO2, The levels of CjvO2 and PbtO2 were (62.93±1.63)%, (99.31±0.94) mL/L and (28.56±1.55) mmHg, which were significantly higher than the control group. Da-jvO2 and CEO2 levels were (51.31±1.13) mL/L and (30.52±0.43)%, which were significantly lower than the control group.Conclusion: Edaravone combined with minimally invasive craniotomy can effectively reduce the level of oxidative stress, improve endothelial function and cerebral oxygen metabolism, and has reliable curative effect. It is worth further clinical application.
文摘Objective:To study the effect of minimally invasive evacuation of hematoma combined with Xingnaojing therapy on neurological function damage and cytokine level in patients with hypertensive cerebral hemorrhage.Methods:A total of 80 patients with hypertensive cerebral hemorrhage treated in our hospital between June 2010 and September 2015 were selected as the research subjects, the treatment methods and test results were reviewed, and then they were divided into the control group (n=45) who accepted minimally invasive evacuation of hematoma alone and the observation group (n=35) who accepted minimally invasive evacuation of hematoma combined with Xingnaojing therapy. Before and after treatment, cerebral blood flow detector was used to detect cerebral blood flow parameters;ELISA method was used to detect serum levels of neurological function indexes and inflammatory cytokines;high performance liquid chromatograph was used to detect serum neurotransmitter levels. Results: Before treatment, the differences in cerebral blood flow parameters, neurological function indexes, inflammatory cytokines and neurotransmitters were not statistically significant between two groups of patients. After treatment, cerebral blood flow parameters Q and V levels of observation group were higher than those of control group while R level was lower than that of control group;serum NSE, NPY, IL-1β, IL-4, IL-6, TNF-α, Glu and Asp contents of observation group were lower than those of control group while BDNF and Gly contents were higher than those of control group.Conclusion: Minimally invasive evacuation of hematoma combined with Xingnaojing therapy can improve the neurological function and regulate the synthesis of inflammatory cytokines and neurotransmitters in patients with hypertension cerebral hemorrhage.
文摘Objective:To explore the therapeutic effect of minimally invasive intracranial hematoma evacuation in the treatment of hypertensive cerebral hemorrhage and the value of dynamic TCD monitoring in predicting the neurological function recovery.Methods: A total of 70 patients with hypertensive cerebral hemorrhage who were admitted in our hospital were included in the study and divided into the minimally invasive group and conservative group with 35 cases in each group according to different treatment protocols. The patients in the two groups were given drug conservative treatments. On this basis, the patients in the minimally invasive group were given urokinase in combined with minimally invasive hematoma puncture with YL-1 type needle. TCD was performed before treatment, 1 d, 5 d, 10 d, and 21 d after treatment. The hematoma and edema volume was calculated. NIHSS was used to evaluate the neurological function recovery.Results: Vs, Vd, and Vm after treatment in the minimally invasive group were significantly elevated, while PI was significantly reduced. Vs, Vd, and Vm after treatment in the conservative group were reduced first and elevated later, while PI was elevated first and reduced later, and reached the lowest/peak 10d after treatment. Vs, Vd, and Vm 5 d, 10 d, and 21 d after treatment in the minimally invasive group were significantly higher than those in the conservative group, while PI was significantly lower than that in the conservative group. The hematoma and edema volume after treatment in the two groups was significantly reduced. The hematoma and edema volume at each timing point was significantly lower than that in the conservative group. NIHSS score after treatment in the minimally invasive group was significantly reduced. NIHSS score in the conservative group was elevated first and reduced later, reached the peak 10d after treatment, and at each timing point was higher than that in the minimally invasive group.Conclusions:The early minimally invasive operation can significantly improve the hematoma adjacent blood flow volume in patients with hypertensive cerebral hemorrhage, and contribute to the neurological function recovery. TCD not only can be applied in the dynamic monitoring of cerebral blood flow volume in patients with hypertensive cerebral hemorrhage, but also has a certain value in evaluating the prognosis of neurological function.
文摘Objective:To observe the clinical efficacy of urokinase in combined with minimally invasive hematoma puncture with YL-1 type needle in the treatment of hypertensive cerebral hemorrhage and the effect on blood sugar and serum CRP.Methods:A total of 84 patients with hypertensive cerebral hemorrhage who were admitted in our hospital were included in the study and divided into the minimally invasive group (n=53) and the conservative group (n=31) according to different treatment protocols. The patients in the two groups were given routine drug treatments. The patients in the observation group were given urokinase in combined with minimally invasive hematoma puncture with YL-1 type needle. The blood sugar and serum CRP levels before and after treatment in the two groups were compared. CT was performed to reexamine the cerebral hematoma and edema volume.Results: The serum CRP and blood sugar levels 3, 7 and 14 d after treatment in the minimally invasive group were significantly lower than those in the conservative group (P<0.05). The cerebral hematoma and edema volume 1, 3, 7, and 14 d after treatment in the minimally invasive group was significantly lower than that in the conservative group (P<0.05).Conclusions: Urokinase in combined with minimally invasive hematoma puncture with YL-1 type needle in the treatment of hypertensive cerebral hemorrhage can significantly alleviate the brain tissue injury, reduce the systemic inflammatory reaction and blood sugar level, and contribute to the rehabilitation.
文摘目的:系统评价颅内血肿微创清除手术联合脑血疏口服液治疗自发性脑出血的疗效及安全性。方法:计算机检索从建库至2023年6月收录于中国期刊全文数据库(China National Knowledge Infrastructure,CNKI)、维普中文科技期刊数据库(VIP Chinese science and technology journal database,VIP)、万方数据库、中国生物医学文献数据库(The Chinese biomedical literature database,CBM)、PubMed、Embase、the Cochrane Library等中英文数据库,结合纳入与排除标准筛选出所有颅内血肿微创清除手术联合脑血疏口服液治疗自发性脑出血的临床随机对照试验,根据Cochrane系统评价手册对纳入研究进行偏倚风险评价,运用Revman5.4软件进行Meta分析,最后采用GRADE系统对结局指标进行证据质量评价。结果:共纳入9项研究,总样本量739例。其中,对照组371例,试验组368例。Meta分析结果显示,与血肿微创清除后仅予常规西医治疗相比,联合应用脑血疏口服液能够提高自发性脑出血患者临床治疗的总有效率[OR=5.47,95%CI=2.28,13.09,P=0.0001],在降低患者美国国立卫生研究所卒中量表评分[MD=−3.42,95%CI=−4.97,−1.87,P<0.0001]和中国脑卒中患者神经功能缺损程度评分[MD=−2.30,95%CI=−3.01,−1.58,P<0.00001],提高患者格拉斯哥昏迷量表(Glasgow coma scale,GCS)评分[MD=1.51,95%CI=1.13,1.89,P<0.00001]和Barthel指数(Barthel index,BI)评分[MD=6.88,95%CI=4.49,9.27,P<0.00001],降低血清S100蛋白[MD=−0.02,95%CI=−0.03,−0.02,P<0.00001]和水通道蛋白4水平[MD=−0.02,95%CI=−0.03,−0.01,P=0.002]方面均具有明显优势。安全性方面,所纳研究均无严重不良反应;2项研究报告有恶心、腹胀、腹泻的胃肠道不适症状,其余研究未报告不良反应发生。结论:现有证据表明,颅内血肿微创清除手术联合脑血疏口服液治疗自发性脑出血疗效确切,能够明显减轻患者神经功能缺损和意识障碍程度,提高患者日常生活能力,改善患者生活质量,且具有一定的安全性。
