本刊首页 > 期刊目次 > 直切口小骨窗经侧裂入路显微手术对高血压基底节脑出血患者水肿带变化及脑脊液细胞因子的影响

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直切口小骨窗经侧裂入路显微手术对高血压基底节脑出血患者水肿带变化及脑脊液细胞因子的影响

  • 浦志一

* 通信作者: 浦志一, 单位:江苏省宝应县人民医院 225800

摘要

【摘要】
目的探究直切口小骨窗经侧裂入路显微手术对HBGH水肿带变化及脑脊液细胞因子的影响。

方法选取我院2014年1月至2016年1月所收治的80例患者,随机分成观察组和对照组,每组患者40例,对照组患者采用骨瓣开颅皮层造瘘入路手术治疗,观察组患者采用直切口小骨窗经侧裂入路手术治疗,对两组治疗前后围手术期指标变化情况;比较两组患者神经功能和日常生活能力恢复情况,并对两组患者术后水肿带和脑脊液细胞因子的变化情况进行比较。

结果观察组患者的手术时间、术中出血量、住院时间、并发症显著优于对照组,差异比具有统计学意义(P<0.05),两组血肿清除率比较差异无统计学意义(P>0.05);观察组患者神经功能和日常生活能力恢复情况显著优于对照组,差异比具有统计学意义(P<0.05); 两组患者的TNF-α、IL-4、6-K-PGF1α自术后12h开始含量均升高,到3d时达到最高值,随后各指标逐渐开始下降,且观察组各指标均显著低于对照组,两组比较差异具有统计学意义(P<0.05)。

结论采用直切口小骨窗经侧裂入路显微手术治疗HBGH能够显著减少手术时间和术中出血量,改善患者水肿带和脑脊液细胞因子水平,改善患者生存质量,是一种理想的治疗

方法

关键词:侧裂入路显微手术;高血压基底节脑出血;水肿带;脑细胞因子

ABSTRACT

[Abstract]
Objective To explore the effect of straight incision via transsylvian approach microsurgery and cerebrospinal fluid changes of cytokines of patients with edema of hypertensive cerebral hemorrhage in basal ganglia. Methds 80 patients in our hospital from January 2014 to January 2016 were patients, randomly divided into observation group and control group, 40 cases in each group, the control group were given craniotomy cortex fistula approach microsurgery treatment, observation group were treated by straight incision via transsylvian approach microsurgery treatment, compared two groups before and after treatment the changes of peri operative indicators; compared two groups of patients with neurological function and daily life ability recovery, compared with the changes of cytokines on cerebrospinal fluid and edema after operation in the two groups.

Results The observation group of patients with operation time, intraoperative bleeding, hospitalization time, complications were significantly better than the control group, the difference is statistically significant (P<0.05), two groups of hematoma removal rate had no significant difference (P>0.05); observation group of patients with nerve function and daily life ability recovery was significantly better than the control group, the difference is statistically significant (P<0.05); the two groups of patients with TNF- alpha, alpha IL-4,6-K-PGF1 from 12h after operation were significantly increased at 3D, reached the highest value, then the index gradually began to decline, and the observation group were significantly lower than the control group, with significant differences between the two groups (P<0.05).

Conclusion   The straight incision via transsylvian approach microsurgery for the treatment of HBGH can significantly reduce the amount of bleeding in the operation time and improve the patients, edema and cerebrospinal fluid cytokine levels, improve the quality of life of patients, is an ideal treatment method.

Key words: lateral fissure approach microsurgery; hypertensive basal ganglia intracerebral hemorrhage; edema zone; brain cell factor

引用本文 / How to Cite This Article

浦志一.直切口小骨窗经侧裂入路显微手术对高血压基底节脑出血患者水肿带变化及脑脊液细胞因子的影响[J]. 国际精神病学杂志, , (): -

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