Soft channel hematoma puncture and drainage for patients with hypertensive intracerebral hemorrhage
Objective To explore the effects of soft channel hematoma puncture and drainage on microRNA-21(miR-21),microRNA-124(miR-124),soluble myeloid cell trigger receptor-1(sTREM-1),procalcitonin(PCT),and neurological function in patients with hypertensive intracerebral hemorrhage(H1CH).Methods Sixty-one patients with HICH who were treated at Ankang Central Hospital from February 2020 to February 2023 were selected for the randomized controlled trial,and were divided into group A(31 cases)and group B(30 cases)by the random number table method.There were 19 males and 12 females in group A;they were(58.98± 10.65)years old;3 cases had hemorrhage on thalamus,2 cases on cerebellum,23 cases on basal ganglia area,1 case on parietal lobe,1 case on frontal lobe,and 1 case on temporal lobe.There were 17 males and 13 females in group B;they were(59.20±10.71)years old;3 cases had hemorrhage on thalamus,3 cases on cerebellum,20 cases on basal ganglia area,1 case on parietal lobe,2 case on frontal lobe,and 1 case on temporal lobe.Group A took the endoscopic intracranial hematoma removal surgery(NEIHE),while group B soft channel hematoma puncture and drainage surgery.All the patients were followed up for 6 months after the surgery.The surgery related indicators,including treatment efficacy 1 month after the surgery,neurological function[National Institute of Health Stroke Scale(NIHSS)]before and 7 d and 1 month after the surgery,the levels of miR-21,miR-124,sTREM-1,and PCT before and 1 month after the surgery,and complications during follow-up were compared between the two groups.t and x2 tests were applied.Results The intraoperative bleeding volume,hospitalization cost,and 72 h hematoma clearance rate in group B were lower than those in group A[(46.65±42.43)ml vs.(71.67±44.76)ml,(65 543.54± 23 521.06)yuan vs.(96 574.76±50 234.54)yuan,and(73.65±12.87)％vs.(88.09±17.65)％];the operation time in group B was shorter than that in group A[(0.65±0.32)h vs.(2.03±0.41)h];the time of hospitalization in the intensive care unit(ICU)in group B was longer than that in group A[(9.65±5.54)d vs.(2.65±1.76)d];there were statistical differences(t=2.239,3.073,3.641,14.622,and 6.696;all P＜0.05).One month after the surgery,the total effective rate in group B was higher than that in group A[93.33％(28/30)vs.70.97％(22/31)],with a statistical difference(x2=5.160;P=0.023).Before the surgery,there was no statistical difference in the neurological function between the two groups(P＞0.05).Seven days and 1 month after the surgery,the scores of neurological function in group B were lower than those in group A[(16.65±3.65)vs.(19.87±3.87)and(6.54± 0.65)vs.(13.76±1.76)],with statistical differences(t=3.341 and 21.114;both P＜0.05).Before the surgery,there were no statistical differences in the levels of miR-21,miR-124,sTREM-1,and PCT between the two groups(all P＞0.05).One month after the surgery,the levels of miR-21,miR-124,sTREM-1,and PCT in group B were better than those in group A[(3.02±0.45)vs.(2.37±0.41),(5.43± 0.45)vs.(6.98±0.67),(6.87±0.23)ng/L vs.(16.87±1.65)ng/L,and(2.76±0.18)μg/L vs.(5.87± 0.79)μg/L],with statistical differences(t=5.901,10.571,32.879,and 21.035;all P＜0.05).There was no statistical difference in the incidence of complications during follow up between group B and group A[46.67％(14/30)vs.25.81％(8/31);x2=2.877;P=0.090].Conclusions In the treatment of patients with HICH,NEIHE is more effective in hematoma removal,and helps shorten ICU hospitalization.However,soft channel hematoma puncture and drainage can significantly shorten operation time,reduce intraoperative bleeding and hospitalization cost,improve their neurological function and treatment efficacy,and regulate the expression levels of miR-21,miR-124,sTREM-1,and PCT.
Hypertensive intracerebral hemorrhageNeuroendoscopic removal of intracranial hematomaSoft channel hematoma puncture and drainage surgeryNeurological function
万方数据
维普
