Effect of ultrasound-guided lumbar square muscle block on stress response in patients undergoing radical gastric cancer surgery

BACKGROUND Radical surgery is a common treatment for patients with gastric cancer;however,it can lead to postoperative complications and intestinal barrier dysfunction.Ultrasound-guided quadratus lumborum block is often used for postoperative analgesia,but its effects on stress response and intestinal barrier function are not well understood.AIM To investigate the effects of an ultrasound-guided quadratus lumborum block on stress response and intestinal barrier function in patients undergoing radical surgery for gastric cancer.METHODS A total of 100 patients undergoing radical surgery for gastric cancer were randomly categorized into observation and control groups.Plasma adrenaline and cortisol levels,intestinal mucosal barrier indexes,and complication rates were compared between the two groups before,during,and 1 day after surgery.RESULTS The observation group had significantly lower plasma adrenaline and cortisol levels during surgery and at 1 day postoperatively than that of the control group(P<0.05).Additionally,intestinal barrier indexes(endotoxin and D-dimer)at 1 day postoperatively were significantly lower in the observation group than in the control group(P<0.05).CONCLUSION Ultrasound-guided quadratus lumborum block could reduce stress response,protect intestinal barrier function,and decrease the incidence of complications in patients undergoing radical surgery for gastric cancer.This technique has the potential for clinical applications.

Short-term effect and long-term prognosis of neuroendoscopic minimally invasive surgery for hypertensive int-racerebral hemorrhage

BACKGROUND Hypertensive intracerebral hemorrhage is a common critical disease of the nervous system,comprising one fifth of all acute cerebrovascular diseases and has a high disability and mortality rate.It severely affects the patients’quality of life.AIM To analyze the short-term effect and long-term prognosis of neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage.METHODS From March 2018 to May 2020,118 patients with hypertensive intracerebral hemorrhage were enrolled in our study and divided into a control group and observation group according to the surgical plan.The control group used a hard-channel minimally invasive puncture and drainage procedure.The observation group underwent minimally invasive neuroendoscopic surgery.The changes in the levels of serum P substances(SP),inflammatory factors[tumor necrosis factor-α,interleukin-6(IL-6),IL-10],and the National Hospital Stroke Scale(NIHSS)and Barthel index scores were recorded.Surgery related indicators and prognosis were compared between the two groups.RESULTS The operation time(105.26±28.35)of the observation group was min longer than that of the control group,and the volume of intraoperative bleeding was 45.36±10.17 mL more than that of the control group.The hematoma clearance rates were 88.58%±4.69%and 94.47%±4.02%higher than those of the control group at 48 h and 72 h,respectively.Good prognosis rate(86.44%)was higher in the observation group than in the control group,and complication rate(5.08%)was not significantly different from that of the control group(P>0.05).The SP level and Barthel index score of the two groups increased(P<0.05)and the inflam-matory factors and NIHSS score decreased(P<0.05).The cytokine levels,NIHSS score,and Barthel index score were better in the observation group than in the control group(P<0.05).CONCLUSION Neuroendoscopic minimally invasive surgery is more complicated than hard channel minimally invasive puncture drainage in the treatment of hypertensive intracerebral hemorrhage;however,hematoma clearance is more thorough,and the short-term effect and long-term prognosis are better than hard channel minimally invasive puncture drainage.

Ultrasound-guided Transversus Abdominis Plane Block Improves Postoperative Analgesia and Early Recovery in Patients Undergoing Retroperitoneoscopic Urologic Surgeries:A Randomized Controlled Double-blinded Trial

Objective To evaluate the effects of ultrasound-guided transversus abdominis plane(TAP) block on postoperative analgesia and early recovery in patients undergoing retroperitoneoscopic urologic surgeries.Methods This was a randomized,controlled,double-blinded trial.Eligible patients scheduled for retroperitoneoscopic urologic surgeries were randomly assigned to two groups.Group TAP received ultrasound-guided TAP block with 0.5% ropivacaine 20 ml at 30 minutes before surgery,and Group C received TAP sham block with normal saline.All patients received retroperitoneoscopic urologic surgeries under general anesthesia.The primary outcome was the severity of pain after surgery.Secondary outcomes included opioids consumption,analgesics,postoperative nausea and vomiting,time to Foley catheter removal and to passage of flatus,length of post-anesthesia care unit stay and hospital stay.Results Eighty patients completed the study,forty cases in each group.Compared to the Group C,the Group TAP had lower visual analogue scale pain scores within two postoperative days(all P<0.05).They also had less consumption of intraoperative fentanyl(2.0±0.5 vs. 3.8±0.7 μg/kg,P<0.05),reduced incidence of postoperative rescue analgesic usage(12.5% vs. 45.0%,P<0.05),and lower incidence of postoperative nausea and vomiting within postoperative 48 hours(12.5% vs. 25.0%,P<0.05) when compared to the Group C.In addition,Group TAP had a shortened post-anesthesia care unit stay(25±8 vs. 49±12 minutes,P<0.05),and a greater proportion of patients discharged within postoperative three days(57.5% vs. 35.0%,P<0.05).Conclusion Preoperative ultrasound-guided TAP block is an effective technique to improve postoperative analgesia and early recovery in patients undergoing retroperitoneoscopic urologic surgeries.

Ultrasound-guided Open Nephron Sparing Surgery without Renal Artery Occlusion for Central Renal Tumors

From January 2008 to January 2013, 11 patients with central renal tumors underwent ultrasound-guided open nephron sparing surgery（ONSS） without renal artery occlusion. We removed the lesions, and the cut edges of the tumors were negative. Thus, we deduced that ultrasound-guided ONSS is suitable for the cases with obscure tumor boundary or multiple lesions. It could achieve the purpose of thoroughly removing lesions, as well as to expand the application range of nephron sparing surgery.

Regional Block Anesthesia in Breast Surgery: What Do We Know So Far?

Breast cancer is the most prevalent cancer in women worldwide, and pain following mastectomy is a major post-surgical complication. This paper highlights the risk factors for chronic pain in breast surgery and evaluates various regional block techniques used to reduce post-operative pain, and minimize hospital stays in high-risk patients. Further research is needed to evaluate the effectiveness of novel regional anaesthesia techniques in an enhanced recovery context, and to assess their role in preventing or reducing chronic pain.

Effects of dexmedetomidine combined with ultrasound-guided nerve block on hemodynamics, immune function and cortisol levels in patients undergoing inguinal surgery

Objective:To investigate the effect of dexmedetomidine combined with ultrasound guided nerve block on the hemodynamics, immune function and cortisol level in the patients undergoing inguinal surgery.Methods:A total of 120 patients who underwent unilateral inguinal surgery in our hospital were randomly divided into control group and observation group, 60 cases in each group. The control group was induced by intravenous anesthesia with sufentanil. The observation group was given dexmedetomidine combined with ultrasound guided ilioinguinal/iliac hypogastric nerve block. Hemodynamics, immune function and cortisol levels were compared between the two groups before and after anesthesia induction. Results:After anesthesia, in surgical incision and recovery time, the levels of HR in the two groups were significantly lower than that before the anesthesia, and the levels of HR in the observation group were significantly lower than that in the control group. After anesthesia, in surgical incision and recovery time, the levels of CD3+, CD4+ and CD4+/CD8+ in the control group were significantly lower than that of the group before anesthesia. After anesthesia, the levels of CD3+, CD4+ and CD4+/CD8+ in the observation group were significantly lower than that of the group before anesthesia. In surgical incision and recovery time, there was no significant difference in the levels of CD3+, CD4+ and CD4+/CD8+ in the observation group before anesthesia. After anesthesia, in surgical incision and recovery time, the levels of CD3+, CD4+ and CD4+/CD8+ in the observation group were significantly higher than that of the control group. The levels of serum PI3K, ET -1, CRP and cortisol of the two groups were significantly higher than those before anesthesia, and the levels of PI3K, ET -1, CRP and cortisol in the serum of the patients in the observation group were significantly lower than those in the control group.Conclusion: The effect of dexmedetomidin combined with ultrasound guided nerve block anesthesia on the patients with inguinal surgery can effectively maintain the hemodynamic stability of the patients and have less influence on the immune function and the stress response. The security is higher.

Complications's prophylaxis in neuroendoscopic endonasal transsphenoidal surgery for pituitary adenomas

Objective To discuss the complicatiaons’s prophylaxis of removing pituitary adenomas by neuroendoscopy in tranasphenoidal surgery. Methods Clinical data of 253 cases treated by endoscopic endanasal transsphenoidal surgery were analysed. Results The total tumor removal was done in 216 (85.38%) cases,subtotal in

The intra-neuroendoscopic technique: a new method for rapid removal of acute severe intraventricular hematoma

The mortality rate of acute severe intraventricular hematoma is extremely high, and the rate of disability in survivors is high. Intraventricular hematoma has always been a difficult problem for clinical treatment. Although minimally invasive endoscopic hematoma evacuation is widely used to treat this disease, the technique still has room for improvement. Equipment for the intra-neuroendoscopic technique（INET） consists of two of our patented inventions： a transparent sheath（Patent No. ZL 200820046232.0） and a hematoma aspirator（Patent No. ZL 201520248717.8）. This study explored the safety and efficacy of INET by comparing it with extraventricular drainage in combination with urokinase thrombolytic therapy. This trial recruited 65 patients with severe intraventricular hemorrhage, including 35（19 men and 16 women, aged 53.2 ± 8.7 years） in the INET group and 30（17 men and 13 women, aged 51.5 ± 7.9 years） in the control group（extraventricular drainage plus urokinase thrombolytic therapy）. Our results showed that compared with the control group, the INET group exhibited lower intraventricular hemorrhage volumes, shorter intensive care-unit monitoring and ventricular drainage-tube placement times, and fewer incidences of intracranial infection, secondary bleeding, and mortality. Thus, the prognosis of survivors had improved remarkably. These findings indicate that INET is a safe and efficient new method for treating severe intraventricular hematoma. This trial was registered with Clinical Trials.gov（NCT02515903）.

Clinical Observation of Disposal Uterine Cavity Observation and Suction Surgery System on Terminating Pregnancy in Very Early Pregnancy

Objective: To compare the clinical effects of uterine cavity observation and suction surgery system with ultrasound guided induced abortion in very early pregnancy induced abortion surgery. Method: Select 80 patients who requested termination of pregnancy due to early pregnancy from August 2022 to April 2023, and analyze the data. 40 patients who underwent ultrasound-guided induced abortion to terminate pregnancy were included in the control group, and 40 patients who underwent uterine cavity observation surgery to terminate pregnancy were included in the observation group. Compare the surgical time, number of times the straw enters the uterine cavity, incidence of complications, and menstrual recovery time between the two groups. Results: There was no statistically significant difference in the surgical time between the observation group and the control group, but the number of times negative pressure straws entered the uterine cavity and the incidence of surgical complications in the observation group were significantly lower than those in the control group (P Conclusion: Applying the uterine cavity observation and suction surgical system to terminate pregnancy in very early pregnancy has the advantages of minimal damage to the uterus and low incidence of surgical complications, greatly protecting the patient’s fertility.

神经内镜手术对幕上高血压性脑出血患者的疗效分析:一项单中心回顾性病例对照研究

目的探讨神经内镜手术治疗幕上高血压性脑出血的效果。方法回顾性选择2022年1-12月我中心收治的42例幕上高血压性脑出血手术患者,根据治疗方式分为神经内镜组(22例)和开颅手术组(20例)。对比两组患者术后残余血肿量、术后90 d预后良好(改良Rankin量表评分为0~3分)率、死亡率及并发症发生率。结果神经内镜组术后残余血肿量<15 mL的患者比例(77.3%,17/22)高于开颅手术组(35.0%,7/20;P=0.022)。神经内镜组和开颅手术组术后90 d预后良好的患者分别为14例(63.6%)和4例(20.0%),差异有统计学意义(P<0.001)。神经内镜组术后再出血发生率(4.5%,1/22)低于开颅手术组(5.0%,1/20;P=0.001)。两组患者术后肺部感染发生率均为100.0%,差异无统计学意义(P=1.000)。神经内镜组的术后90 d死亡率(13.6%,3/22)低于开颅手术组(30.0%,6/20;P<0.001)。结论神经内镜手术治疗可提高幕上高血压性脑出血患者的血肿清除率,降低并发症发生率及死亡率,改善患者预后。

神经内镜微创手术治疗高血压脑出血的效果分析

目的:分析神经内镜微创手术治疗高血压脑出血的效果。方法:选取2020年1月—2022年12月新疆生产建设兵团第一师医院收治的高血压脑出血患者120例作为研究对象,依据双色球法分为观察组与对照组,各60例。对照组采取开颅血肿清除术治疗,观察组采取神经内镜微创手术治疗。比较两组临床疗效。结果:观察组手术时间短于对照组,术中出血量少于对照组,血肿清除率高于对照组,差异有统计学意义(P<0.001)。观察组术后并发症发生率低于对照组,差异有统计学意义(P=0.031)。观察组治疗总有效率高于对照组,差异有统计学意义(P=0.028)。观察组重症监护室观察时间及整体治疗时间短于对照组,差异有统计学意义(P<0.001)。结论:神经内镜微创手术治疗高血压脑出血的效果较好,其手术时间短、术中出血量少、血肿清除率高,术后并发症发生率低,患者恢复速度快。

神经内镜辅助下经鼻蝶窦手术治疗垂体瘤的效果及对嗅觉功能、神经内分泌激素水平的影响

目的:探讨神经内镜辅助下经鼻蝶窦手术治疗垂体瘤的效果及对嗅觉功能、神经内分泌激素水平的影响。方法:回顾性将我院2018年03月至2022年02月收治的垂体瘤患者58例作为此次的研究对象,其中采用显微镜辅助下进行经鼻蝶窦手术的28例作为对照组,神经内镜辅助下进行经鼻蝶窦手术的30例作为观察组,均观察至患者出院,并进行随访1年。比较两组围术期指标,术后1个月视力下降、头痛及性功能障碍缓解率,术前、术后1个月激素水平、T细胞亚群、生活质量评分、嗅觉功能,研究期间并发症发生情况,随访1年后复发情况。结果:与对照组比较,观察组的出血量相对更少,术后住院时间较短,肿瘤全切率相对更高;术后1个月,与对照组进行比较,观察组视力下降、头痛及性功能障碍缓解率均相对更高;相比术前,两组术后1个月血清泌乳素(PRL)、促甲状腺素(TSH)、生长激素(HGH)、促肾上腺皮质激素(ACTh)水平均降低,观察组低于对照组,外周血CD3^(+)、CD4^(+)水平、CD4^(+)/CD8^(+)值、社会功能、躯体功能、心理功能、物质生活状态各项生活质量评分术后1个月则均升高,观察组高于对照组;与术前比较,两组术后1个月嗅觉功能均升高,但观察组低于对照组;研究期间,观察组并发症总发生率3.33%低于对照组的25.00%;随访1年后,观察组的复发率0.00%同样低于对照组的14.29%(P<0.05)。结论:神经内镜辅助下经鼻蝶窦手术可有效提高垂体瘤患者的生活质量以及视力下降、头痛等临床症状缓解率,缩短住院时间,同时还能够改善患者的免疫功能以及嗅觉功能,稳定患者神经内分泌激素水平,降低并发症发生以及复发率。

神经内镜微创手术对高血压脑出血患者脑血流动力学的影响分析

目的探究神经内镜微创手术对高血压脑出血患者脑血流动力学的影响。方法选取2020年12月至2024年3月丹阳市人民医院(南通大学附属丹阳医院)收治的80例高血压脑出血患者,随机分为两组,对照组采用开颅血肿清除术治疗,观察组采用神经内镜微创手术治疗。对比两组脑血流动力学指标、术后并发症发生情况。结果观察组手术后前动脉及双侧大脑中动脉的平均血流速度、收缩期峰值血流速度均快于对照组,术后并发症总发生率低于对照组,P<0.05。结论神经内镜微创手术应用于高血压脑出血患者的临床治疗不仅可改善其脑血流动力学情况,还可极大程度地降低其术后并发症发生率。

脑室外引流术与神经内镜微创手术治疗严重高血压脑室内出血的疗效比较——一项单中心回顾性研究

目的分析神经内镜微创手术与传统脑室穿刺引流术治疗严重高血压脑室内出血的安全性及疗效。方法回顾性分析2020年7月至2023年7月采用神经内镜微创术式清除血肿50例(内镜组)与传统脑室外引流术治疗44例(引流组)的临床资料,观察两组血肿清除率,日常生活能力量表(ADL)分级情况,术后脑积水、继发出血、颅内感染、肺部感染发生率。结果术后内镜组患者血肿清除率大于60%患者比例和ADL分级为Ⅰ、Ⅱ、Ⅲ级者占比均明显高于引流组〔血肿清除率大于60%患者比例:88.0%(44/50)比47.7%(21/44),χ^(2)=17.794,P<0.001;ADL分级为Ⅰ、Ⅱ、Ⅲ级者占比:94.0%(47/50)比77.3%(33/44),χ^(2)=5.459,P=0.019〕,并发症发生率明显低于引流组〔8.0%(4/50)比34.1%(15/44),χ^(2)=9.879,P=0.002〕。结论与脑室外引流术相比,神经内镜微创手术治疗严重高血压脑室内出血可获得更好的治疗结果,达到较高血肿清除率,同时较少发生术后并发症。

血清高迁移率族蛋白Bl、白细胞介素-6与高血压性脑出血患者神经内镜微创术后神经功能及预后的关系

目的探讨血清高迁移率族蛋白Bl(HMGB1)、白细胞介素-6(IL-6)水平与高血压性脑出血(HICH)患者神经内镜微创术后神经功能及预后的关系。方法选取2018年6月至2022年12月许昌市中心医院收治的336例HICH患者作为研究对象,根据神经内镜微创术后神经功能缺损程度分为轻型组、中型组及重型组,并根据术后预后状态分为预后良好组和预后不良组。分析HICH患者血清HMGB1、IL-6水平与美国国立卫生研究院卒中量表(NIHSS)评分的相关性及对预后的预测效能,探讨影响HICH患者预后的因素。结果HICH患者术后血清HMGB1、IL-6水平及NIHSS评分均低于术前,且二者与NIHSS评分均呈正相关;血清HMGB1和IL-6水平均随神经功能缺损程度的增加而升高,预后不良组患者术后血清HMGB1和IL-6水平均高于预后良好组;术中出血量、出血部位、出血破入脑室、术前格拉斯哥昏迷(GCS)评分、血肿清除率、NIHSS评分、HMGB1和IL-6均为HICH患者预后不良的危险因素;术后血清HMGB1和IL-6二者联合检测对患者预后的预测效能优于各自单独检测(Z_(二者联合-HMGB1)=2.236、Z_(二者联合-IL-6)=1.974,P=0.034、0.017)。结论HICH患者行神经内镜微创术后血清HMGB1、IL-6水平与其神经功能康复密切相关,二者联合检测对患者的预后状态具有预测效能。

神经内镜下血肿清除术治疗高血压脑出血患者的临床疗效研究

目的分析两神经内镜下血肿清除术与传统骨瓣开颅手术治疗高血压脑出血患者的临床应用效果。方法回顾性选取2021年1月—2023年12月东莞市滨海湾中心医院收治的62例高血压脑出血患者的临床资料,根据不同的手术方法分为两组,观察组采用神经内镜下血肿清除术,对照组采用传统骨瓣开颅手术。对比两组手术相关指标、预后相关评分及术后并发症发生情况。结果观察组患者手术相关指标、预后相关评分均优于对照组,差异有统计学意义(P均<0.05)。观察组并发症发生率为6.45%(2/31),低于对照组的32.26%(10/31),差异有统计学意义(χ^(2)=6.613,P<0.05)。结论神经内镜下血肿清除术可以有效提高血肿清除率,缩短患者的住院时间并有助于改善患者预后,减少术后并发症的发生。

软通道血肿穿刺引流术治疗高血压脑出血患者的效果

目的探讨软通道血肿穿刺引流术对高血压脑出血(HICH)患者微小核糖核酸-21(miR-21)、微小核糖核酸-124(miR-124)、可溶性髓系细胞触发受体-1(sTREM-1)、降钙素原(PCT)及神经功能的影响。方法本研究为随机对照试验,选取2020年2月至2023年2月安康市中心医院接受治疗的61例HICH患者作为研究对象,采用随机数字表法分为A组(31例)和B组(30例)。A组男19例、女12例,年龄(58.98±10.65)岁,出血部位:丘脑3例、小脑2例、基底节区23例、顶叶1例、额叶1例、颞叶1例。B组男17例、女例13例,年龄(59.20±10.71)岁,出血部位:丘脑3例、小脑3例、基底节区20例、顶叶1例、额叶2例、颞叶1例。A组给予神经内镜颅内血肿清除术(NEIHE),B组给予软通道血肿穿刺引流术(SCPD),术后均随访6个月。对比两组患者手术相关指标,术后1个月治疗效果,术前、术后7 d、1个月神经功能[美国国立卫生研究院卒中量表(NIHSS)评估],术前、术后1个月的miR-21、miR-124、sTREM-1、PCT水平及随访期间并发症情况。统计学方法采用t检验、χ^(2)检验。结果B组术中出血量、住院费用及72 h血肿清除率均低于A组[(46.65±42.43)ml比(71.67±44.76)ml、(65543.54±23521.06)元比(96574.76±50234.54)元、(73.65±12.87)%比(88.09±17.65)%],手术时间短于A组[(0.65±0.32)h比(2.03±0.41)h],重症监护病房(ICU)住院时间长于A组[(9.65±5.54)d比(2.65±1.76)d],差异均有统计学意义(t=2.239、3.073、3.641、14.622、6.696,均P<0.05)。术后1个月,B组总有效率为93.33%(28/30),高于A组的70.97%(22/31),差异有统计学意义(χ^(2)=5.160,P=0.023)。术前,两组患者神经功能比较,差异无统计学意义(P>0.05);术后7 d及术后1个月,B组神经功能评分均低于A组[(16.65±3.65)分比(19.87±3.87)分、(6.54±0.65)分比(13.76±1.76)分],差异均有统计学意义(t=3.341、21.114,均P<0.05)。术前,两组患者miR-21、miR-124、sTREM-1、PCT水平比较,差异均无统计学意义(均P>0.05);术后1个月,B组血清miR-21水平高于A组[(3.02±0.45)比(2.37±0.41)],miR-124、sTREM-1、PCT水平均低于A组[(5.43±0.45)比(6.98±0.67)、(6.87±0.23)ng/L比(16.87±1.65)ng/L、(2.76±0.18)μg/L比(5.87±0.79)μg/L],差异均有统计学意义(t=5.901、10.571、32.879、21.035,均P<0.05)。B组随访期间并发症发生率为46.67%(14/30),与A组25.81%(8/31)比较,差异无统计学意义(χ^(2)=2.877,P=0.090)。结论在HICH治疗中,NEIHE血肿清除效果较好,有助于缩短ICU住院时间,但SCPD可减少术中出血量及住院费用,缩短手术时间,改善神经功能,调节患者miR-21、miR-124、sTREM-1、PCT表达水平,提高治疗效果。

慢性硬膜下血肿行神经内镜术后血肿复发及其危险因素分析

目的:探究慢性硬膜下血肿患者开展神经内镜术后血肿复发情况及危险因素,为改善患者预后提供参考。方法:回顾性选择2018年9月至2022年1月在开封市中心医院被确诊为慢性硬膜下血肿并接受神经内镜术治疗的190例患者为研究对象,按照对其随访12个月结果的差异将其区分为复发组(21例)和无复发组(169例),采用logistic回归模型分析患者血肿复发的危险因素。结果:190例患者中有21例出现了血肿复发,复发率为11.05%,无复发169例;单因素分析结果显示,两组患者在术后残余气体量、凝血功能是否异常、术后是否服用他汀类药物、血肿侧别、血肿密度、术前血肿厚度方面比较,差异均具有统计学意义(P<0.05);多因素logistic回归分析显示,有凝血功能异常、术后未服用他汀类药物、高密度血肿、双侧血肿、术前血肿厚度>25 mm是导致慢性硬膜下血肿行神经内镜术后血肿复发的独立危险因素(P<0.05)。结论:慢性硬膜下血肿行神经内镜术后血肿复发率较高,其中凝血功能异常、术后未服用他汀类药物、高密度血肿、双侧血肿、术前血肿厚度>25 mm是导致复发的独立危险因素,建议对存在上述危险因素的患者积极开展随访干预,以改善患者预后。

神经内镜微创手术治疗对高血压性脑出血患者血清BDNF、TNF-α和MMP-9水平的影响

目的探讨高血压性脑出血(hypertensive intracerebral hemorrhage,HICH)采取神经内镜微创手术对脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和基质金属蛋白酶-9(matrix metalloproteinase-9,MMP9)水平的影响。方法非随机选取2022年1月—2023年3月齐河县人民医院收治的104例HICH患者为研究对象,根据治疗方法不同分为观察组和对照组,各52例。其中对照组行小骨窗开颅显微术治疗,观察组行神经内镜微创术治疗。对比两组围术期指标、血清指标以及并发症发生情况。结果与对照组相比,观察组手术时间更短,手术出血量少,血肿清除率更高,差异有统计学意义(P均<0.05)。术后5 d,观察组患者BDNF水平(33.02±3.16)μg/L高于对照组(28.04±3.29)μg/L,差异有统计学意义(t=10.915,P<0.05);观察组TNF-α、MMP9水平低于对照组,差异有统计学意义(P均<0.05)。观察组术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论应用经神经内镜下微创手术治疗HICH效果更好,能明显提高BDNF水平并下调TNF-α、MMP9水平,且术后并发症发生率低。

神经内镜硬通道微创术与小骨窗开颅血肿清除术治疗慢性硬膜下血肿患者的效果比较

目的:比较神经内镜硬通道微创术与小骨窗开颅血肿清除术治疗慢性硬膜下血肿患者的效果。方法:选取2021年2月至2023年3月该院收治的60例慢性硬膜下血肿患者进行前瞻性研究,按照随机数字表法将其分为研究组和对照组各30例。对照组采用小骨窗开颅血肿清除术治疗,研究组采用神经内镜硬通道微创术治疗。比较两组临床症状改善指标(对侧血肿厚度、中线移位幅度)水平、预后良好率和术后并发症发生率。结果:研究组对侧血肿厚度、中线移位幅度均小于对照组,差异有统计学意义(P<0.05);研究组预后良好率高于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:神经内镜硬通道微创术治疗慢性硬膜下血肿患者可提高预后良好率,以及降低临床症状改善指标水平的效果优于小骨窗开颅血肿清除术治疗。