早期微孔手术治疗中小量基底节脑出血后脑水肿的疗效及对血清炎性因子的影响

Clinical efficacy of early micro-porous surgery in treatment of patients with encephaledema after small-and moderate-volume basal ganglia hemorrhage and its influence on serum inflammatory factors

  • 摘要: 目的 探讨早期微孔手术治疗中小量基底节脑出血后脑水肿的疗效及对患者血清炎性因子的影响.方法 将中小量基底节脑出血患者104例随机分为对照组与观察组各52例.对照组采用内科保守治疗,观察组采用早期微孔手术治疗.观察2组治疗后3、14 d的肿体体积及血肿清除时间;检测2组治疗前、治疗后3d血清中自细胞介素石(IL-6)、白介素-1β(IL-1β)及肿瘤坏死因子-α(TNF-α)水平;治疗前、治疗后3周运用美国国立卫生研究院卒中量表(NIHSS)量表、日常生活能力表Barthel指数(BI)评估患者神经功能.结果 治疗后3、14d,观察组肿体体积较对照组显著减小(P<0.05),肿体清除时间显著短于对照组(P<0.01);治疗后3d,2组血清IL-6、IL-1β及TNF-α水平显著下降,且观察组下降更为显著(.P<0.05或P<0.01);治疗后3周,2组的NIHSS评分降低,BI指数升高,且观察组改善程度更显著(P<0.05).结论 早期微孔手术可明显减轻脑出血后脑水肿程度,对患者神经功能恢复有较大优势.

     

    Abstract: Objective To explore the clinical efficacy of early micro-porous surgery in the treatment of patients with encephaledema after small-and moderate-volume basal ganglia hemorrhage and its influence on serum inflammatory factors.Methods A total of 104 patients with small-and moderate-volume basal ganglia hemorrhage were randomly divided into control group and observation group,52 cases in each group.Control group was treated with conventional treatment,while observation group was treated with early micro-porous surgery.The volume of encephaledema and clearance time of hematoma 3 d and 14 d after treatment were observed in both groups.The levels of serum interleukin-6 (IL-6),IL-13 and tumor necrosis factors-α (TNF-o) were detected before treatment and 3 d after treatment in both groups.National Institutes of Health Stroke Scale (NIHSS) and Activities of Daily Life Function Assessment Scale Barthel index (BI) were used before and 3 weeks after treatment to evaluate patients' neurological function.Results The 3 d and 14 d after treatment,observation group was significantly smaller in volume of encephaledema (P < 0.05) and shorter in clearance time of hematoma (P <0.01) when compared with control group.Three days after treatment,levels of serum IL-6,IL-1 β and TNF-α decreased significantly in both groups,which decreased more significantly in observation group than in control group (P <0.05 or P <0.01).Three weeks after treatment,NIHSS score decreased significantly while BI increased significantly in both groups,which improved more significantly in observation group than in control group (P < 0.05).Conclusion Early micro-porous surgery can significantly relieve the severity of encephaledema after intracerebral hemorrhage,and has greater advantages in recovering patients' neurological function.

     

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