贵州医科大学学报

2016, v.41;No.190(07) 858-861

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立体定向微创穿刺颅内血肿清除术对脑出血患者的疗效
Efficacy of Stereotactic Minimally Invasive Procedures Removing Intracranial Hemotoma in Patients with Intracerebral Hemorrhage

宋安军;伍国锋;任思颖;王丽琨;毛远红;熊洁;秦冠南;
SONG Anjun;WU Guofeng;REN Siying;WANG Likun;MAO Yuanhong;XIONG Jie;QIN Guannan;Department of Emergency Neurology,the Affiliated Hospital of Guizhou Medical University;

摘要(Abstract):

目的:探讨立体定向微创穿刺颅内血肿清除术对脑出血患者的疗效及血清CRP影响。方法:60例脑出血患者均分为微创手术组(行立体定向微创穿刺颅内血肿清除术)和药物治疗组,比较2组患者的血肿清除时间、住院时间及复方甘露醇用量,记录2组患者入院及出院时的神经功能缺损(NIHSS)评分,采用免疫透射比浊法测定2组患者入院时、微创手术后1 d时或同时点药物治疗组、出院时的血清C反应蛋白水平。结果:微创手术组血肿清除时间、住院时间及复方甘露醇用量少于药物治疗组,差异有统计学意义(P<0.05);入院时,2组患者血清CRP水平、NIHSS评分比较,差异无统计学意义(P>0.05);微创手术组患者手术后1 d时的血清CRP水平高于治疗前和同时点药物治疗组(P<0.05),而药物组(微创组手术后1d的同时点)血清CRP水平与入院时比较,差异无统计学意义(P>0.05);出院时2组患者血清CRP水平处于正常值内(P>0.05),但微创手术组高于药物治疗组(P<0.05);出院时,2组患者NIHSS评分均低于入院时,微创手术组降低更明显,差异有统计学意义(P<0.05)。结论:立体定向微创颅内血肿清除术能减少脑组织的损害程度,疗效优于药物治疗,术后1 d时血清CRP水平升高。
Objective: To explore the efficacy of stereotactic minimally invasive procedures removing intracranial hemotoma in patients with intracerebral hemorrhage. Methods: 60 patients with cerebral hemorrhage were divided into minimally invasive surgery group and drug treatment group,30 cases in each group. Hematoma removal time,compound mannitol dosage,and hospital stays of two groups patients were compared. Neurological deficit( NIHSS) score of the two groups of patients were recorded at admission and discharge. The serum levels of C reactive protein( CRP) in the two groups were measured by immune transmission turbidity method at admission,at 1 d after minimally invasive surgery or at the same time point of drug treatment group. Results: Hematoma clearance time,hospitalization time and compound mannitol dosage in minimally invasive surgery group were less than those of the drug treatment group,and the difference was statistically significant( P < 0. 05). There were no statistically significant differences in serum CRP level and NIHSS between the two groups at admission( P > 0. 05). The serum CRP level in minimally invasive surgery group at 1 d after minimally invasive surgery was significantly higher than before surgery and than that of drug treatment group at the same time point( P < 0. 05),while there was no statistically significant differences in the serum CRP levelbetween at admission and at the same time point of minimally invasive surgery( P > 0. 05). At the time of discharge,the serum CRP level of the two groups was in the normal value( P > 0. 05),but the serum CRP level in minimally invasive surgery group was significantly higher than that of the drug treatment group( P < 0. 05). When discharged,NIHSS score in the two groups of patients with were lower than at admission,which decreased more significantly in minimally invasive surgery group,and the difference was statistically significant( P < 0. 05). Conclusions: Stereotactic minimally invasive procedures can reduce the damage degree of brain tissue,curative effect is better than drug treatment,and the level of serum CRP was increased at 1 d after minimally invasive surgery.

关键词(KeyWords): 脑出血;立体定向微创术;神经功能缺损评分;C反应蛋白质;头部损伤,穿透性
cerebral hemorrhage;stereotactic minimally invasive procedures;neurological deficit score;C reactive protein;head injury,penetrativity

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作者(Author): 宋安军;伍国锋;任思颖;王丽琨;毛远红;熊洁;秦冠南;
SONG Anjun;WU Guofeng;REN Siying;WANG Likun;MAO Yuanhong;XIONG Jie;QIN Guannan;Department of Emergency Neurology,the Affiliated Hospital of Guizhou Medical University;

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DOI: 10.19367/j.cnki.1000-2707.2016.07.029

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