| 贾振锋,张晓娟,高云霞,王黎华,孙 立,王乃柱.小骨窗显微手术治疗基底节区高血压脑出血的效果分析及对血清CCCK-18、CTRP-3水平的影响[J].,2020,(10):1956-1960 |
| 小骨窗显微手术治疗基底节区高血压脑出血的效果分析及对血清CCCK-18、CTRP-3水平的影响 |
| Clincial Efficacy of Microsurgery with Small Bone Window in the Treatment of Hypertensive Cerebral Hemorrhage in Basal Ganglia and Its Effect on the Levels of CCCK-18 and CTRP-3 in Serum |
| 投稿时间：2020-01-05 修订日期：2020-01-28 |
| DOI：10.13241/j.cnki.pmb.2020.10.035 |
| 中文关键词: 小骨窗显微手术 基底节区高血压脑出血 血肿清除率 并发症 预后 |
| 英文关键词: Microsurgery of small bone window Hypertensive cerebral hemorrhage in basal ganglia Hematoma clearance rate Complication Prognosis |
| 基金项目:邯郸市科学技术研究与发展计划项目(1823208020ZC) |
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| 中文摘要: |
| 摘要 目的：探讨小骨窗显微手术治疗基底节区高血压脑出血的效果及对血清gaspase切割的细胞角蛋白18(CCCK-18)、补体C1q肿瘤坏死因子相关蛋白3(CTRP-3)水平的影响。方法：选取2016年5月至2018年5月我院收治的160例基底节区高血压脑出血患者，按照随机数表法将其分为观察组(n=82)和对照组(n=78)。对照组采用传统大骨瓣开颅术治疗，观察组采用小骨窗显微手术治疗。观察和比较两组的临床疗效，血肿清除率、术中出血量、术后意识恢复时间、住院时间，治疗前后NIHSS、ADL评分、血清CCCK-18、CTRP-3水平的变化及并发症的发生情况。结果：治疗后，观察组总有效率显著高于对照组[95.12% vs. 79.48%](P＜0.05)；血肿清除率、术中出血量、术后意识恢复时间、住院时间均显著优于对照组［(93.62±3.58) % vs. (85.40±2.19) %，(92.47±12.56) mL vs. (189.25±26.47) mL，(2.01±0.58) d vs. (8.69±2.03) d，(13.39±2.08) d vs. (19.45±3.76) d］(P＜0.05)；NIHSS评分显著低于对照组［(9.76±1.42) 分 vs. (20.57±3.26) 分］(P＜0.05)；ADL评分显著高于对照组[(86.42±8.64) 分vs. (75.39±7.02) 分](P＜0.05)；血清CCCK-18水平显著低于对照组 [(201.76±32.59) U/L vs. (237.57±39.20) U/L，(29.59±5.19) ng/mL vs. (42.97±7.94) ng/mL](P＜0.05)；CTRP-3水平显著高于对照组[(289.59±35.19)ng/mL vs. (232.97±27.94)ng/mL](P＜0.05)；并发症总发生率显著低于对照组[3.65%(3/82) vs. 14.10%(11/78)](P＜0.05)。结论：小骨窗显微手术治疗基底节区高血压脑出血的疗效显著，可更有效清除血肿，缓解血肿压迫，改善神经功能，减少继发性损伤，安全性高，可能与其降低血清CCCK-18水平及升高CTRP-3水平有关。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinical efficacy of microsurgery with small bone window in the treatment of hypertensive cerebral hemorrhage in basal ganglia and its effect on the levels of CCCK-18 and CTRP-3 in Serum. Methods: 160 patients with hypertensive cerebral hemorrhage in basal ganglia who were treated from May 2016 to May 2018 in our hospital were selected as research objects. According to random number table, those patients were divided into the observation group (n=82) and the control group (n=78). The control group was treated with traditional large bone flap craniotomy, while the observation group treated with microsurgery of small bone window. The clinical effect, hematoma clearance rate, intraoperative bleeding volume, postoperative consciousness recovery time, hospital stay time, NIHSS, ADL scores before and after treatment, changes in serum ccck-18, CTRP-3 levels and the incidence of complications were o observed and compared between the two groups. Results: After treatment, the total effective rate of observation group was significantly higher than that of the control group[95.12% vs. 79.48%](P＜0.05). The hematoma clearance rate, intraoperative bleeding volume, postoperative consciousness recovery time and hospitalization time were significantly better than those in the control group［(93.62±3.58) % vs. (85.40±2.19) %, (92.47±12.56) mL vs. (189.25±26.47) mL, (2.01±0.58) d vs. (8.69±2.03) d, (13.39±2.08) d vs. (19.45±3.76) d］(P＜0.05). NIHSS score was significantly lower than that of the control group［(9.76±1.42) scores vs. (20.57±3.26) scores］(P＜0.05). ADL score was significantly higher than that of the control group[(86.42±8.64) scores vs. (75.39±7.02) scores](P＜0.05). The levels of ccck-18 in serum were significantly lower than those in the control group[(201.76±32.59) U/L vs. (237.57±39.20) U/L](P<0.05). The level of CTRP-3 was significantly higher than that of the control group[(289.59±35.19)ng/mL vs. (232.97±27.94)ng/mL](P＜0.05). The total incidence of complications was significantly lower than that of the control group[3.65%(3/82) vs.14.10%(11/78)] (P<0.05). Conclusion: Microsurgery combined with small bone window is effective on hypertensive intracerebral hemorrhage in basal ganglia. It can clear hematoma more effectively relieve the hematoma compression, improve the nerve function, reduce the secondary injury, which may be related to the decrease of serum CCCK-18 level and increase of CTRP-3level. |
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