| 邵 政,柳泽彬,肖铮铮,李 丽,范 波.不同手术时机小骨窗微创血肿清除术对高血压脑出血患者炎症因子、预后及血清Ang-1、ET、AVP水平的影响[J].,2021,(20):3979-3983 |
| 不同手术时机小骨窗微创血肿清除术对高血压脑出血患者炎症因子、预后及血清Ang-1、ET、AVP水平的影响 |
| Effects of Minimally Invasive Hematoma Evacuation with Small Bone Window at Different Operation Time on Inflammatory Factors, Prognosis and Serum Levels of Ang-1, ET and AVP in Patients with Hypertensive Intracerebral Hemorrhage |
| 投稿时间：2021-03-08 修订日期：2021-03-31 |
| DOI：10.13241/j.cnki.pmb.2021.20.036 |
| 中文关键词: 超早期 早期 小骨窗微创血肿清除术 高血压脑出血 炎症因子 预后 血管生成素-1 内皮素 血管升压素 |
| 英文关键词: Super early Early Minimally invasive hematoma evacuation with small bone window Hypertensive intracerebral hemorrhage Inflammatory factors Prognosis Angiopoietin-1 Endothelin Vasopressin |
| 基金项目:国家自然科学基金项目(U1404822) |
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| 摘要 目的：探讨不同手术时机小骨窗微创血肿清除术对高血压脑出血（HICH）患者炎症因子、预后及血清血管生成素-1（Ang-1）、内皮素（ET）、血管升压素（AVP）水平的影响。方法：选取2018年1月~2019年12月期间我院收治的130例HICH患者，根据手术时机的不同分为早期组（n=64，发病6~24 h内进行手术）和超早期组（n=66，发病6 h内进行手术），对比两组围术期指标、炎症因子[白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、超敏C反应蛋白（hs-CRP）]水平、预后、血清Ang-1、ET、AVP水平、改良Barthel指数（BI）、美国国立卫生研究院卒中量表（NIHSS）评分、并发症发生情况。结果：超早期组住院时间短于早期组，术中出血量少于早期组（P<0.05），两组血肿清除率、手术时间对比无差异（P>0.05）。术后7 d，早期组、超早期组IL-6、TNF-α、hs-CRP、Ang-1、ET、AVP、NIHSS评分均较术前下降，且超早期组低于早期组（P<0.05）。术后7 d，早期组、超早期组BI评分较术前升高，且超早期组高于早期组（P<0.05）。两组并发症发生率比较无差异（P>0.05），超早期组生存率高于早期组（P<0.05）。结论：对HICH患者发病6 h内进行小骨窗微创血肿清除术，可有效减轻手术创伤，改善脑组织缺血状态，促进生活自理能力和神经功能的恢复，降低血清炎症因子水平，改善患者预后，且安全性较好。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of minimally invasive hematoma evacuation with small bone window at different operation time on inflammatory factors, prognosis and serum levels of angiopoietin-1 (Ang-1), endothelin (ET) and vasopressin (AVP) in patients with hypertensive intracerebral hemorrhage (HICH). Methods: From January 2018 to December 2019, 130 patients with HICH in our hospital were selected, and divided into early group (n=64, operation within 6~24 hours after onset) and super early group (n=66, operation within 6 hours after onset) according to different operation time. Perioperative indexes, inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor -α (TNF-α), high sensitivity C-reactive protein (hs-CRP)] levels, prognosis, serum Ang-1, ET, AVP levels, modified Barthel Index (BI), National Institutes of Health Stroke Scale (NIHSS) score, occurrence of complications were compared between the two groups. Results: The hospitalization time of super early group was shorter than that of early group, and intraoperative blood loss was less than that of early group(P<0.05). There was no difference in hematoma clearance rate and operation time between the two groups(P>0.05). 7d after operation, the IL-6, TNF -α, hs-CRP, Ang-1, ET, AVP and NIHSS score of early group and super early group were decreased compared with those before operation, and those of super early group were lower than those of early group(P<0.05). 7 d after operation, the BI score of early group and super early group was increased compared with that before operation, and that of super early group was higher than that of early group(P<0.05). There was no difference in the incidence of complications between the two groups (P>0.05). The survival rate of the super early group was higher than that of the early group (P<0.05). Conclusion: Minimally invasive hematoma evacuation with small bone window within 6 hours after onset of HICH can effectively reduce surgical trauma and improve the ischemic state of brain tissue, promote the recovery of self-help ability and neurological function, reduce the serum inflammatory factors levels, improve the prognosis of patients, improve the quality of life of patients and the security is good. |
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