首页|基于颅内压和血脑屏障指数评估软通道微创穿刺血肿清除术治疗高血压脑出血的疗效

基于颅内压和血脑屏障指数评估软通道微创穿刺血肿清除术治疗高血压脑出血的疗效

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目的 基于颅内压和血脑屏障指数评估软通道微创穿刺血肿清除术治疗高血压脑出血的疗效。方法 选取2019 年 2 月至 2021 年 9 月联勤保障部队第九〇四医院收治的 78 例高血压脑出血患者,按不同治疗方式分为对照组(n=35)与观察组(n=43)。对照组实施开颅血肿清除手术,观察组实施软通道微创穿刺血肿清除术。比较观察组和对照组手术相关指标(手术时间、术中出血量、引流时间)、颅内压变化、血脑屏障指数及疗效。结果 观察组手术时间和引流时间短于对照组,术中出血量少于对照组(P<0。05)。相对于手术结束时,术后 24 h观察组和对照组颅内压均有所下降(P<0。05),且观察组手术结束时及术后 24 h的颅内压均低于对照组(P<0。05)。术后观察组和对照组血脑屏障指数下降,且观察组低于对照组(P<0。05)。观察组患者有效率(93。02%)高于对照组(74。29%),差异有统计学意义(P<0。05)。结论 软通道微创穿刺血肿清除术可有效降低高血压脑出血患者颅内压水平与血脑屏障指数,疗效佳,且手术时间缩短、术中出血量减少,可作为临床高血压脑出血患者治疗的首选手段之一。
Effect of soft channel minimally invasive puncture hematoma evacuation on hypertensive intracerebral hemorrhage based on intracranial pressure and blood-brain barrier index
Objective To evaluate the efficacy of soft channel minimally invasive puncture hematoma evacuation in treatment of hypertensive intracerebral hemorrhage based on intracranial pressure and blood-brain barrier index.Methods A total of 78 patients with hypertensive intracerebral hemorrhage who were admitted to No.904 Hospital of Joint Logistics Support Force of PLA from February 2019 to September 2021 were enrolled and divided into two groups according to different treatment methods.Control group(n=35)received craniotomy,and observation group(n=43)received soft channel minimally invasive puncture hematoma evacuation.Operation related indexes(operation time,intraoperative blood loss,and drainage time),intracranial pressure,blood-brain barrier index and therapeutic effect were compared between two groups.Results The observation group had shorter operation time,shorter drainage time and less intraoperative blood loss than the control group(P<0.05).Intracranial pressure at 24 h postoperatively was lower than that at the end of surgery in both groups(P<0.05).Intracranial pressure at the end of surgery and 24 h postoperatively in the observation group was lower than those in the control group(P<0.05).The blood-brain barrier index was decreased in both groups after surgery,and the index in the observation group was lower than that in the control group(P<0.05).The overall efficacy rate of the observation group was significantly higher than that of the control group(93.02%vs 74.29%,P<0.05).Conclusion Soft channel minimally invasive puncture hematoma evacuation can effectively reduce the intracranial pressure and blood-brain barrier index in patients with hypertensive intra cerebral hemorrhage,with shorter operation time and less intraoperative bleeding.It can be used for preferred surgical procedure for hypertensive intra cerebral hemorrhage.

Hypertensive intracerebral hemorrhageSoft channel minimally invasive puncture hematoma evacuationIntracranial pressureBlood brain barrier indexEfficacy

张菊芬、王素琴、吴艳、周劲旭

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214000 江苏无锡,联勤保障部队第九〇四医院神经外科

214000 江苏无锡,联勤保障部队第九〇四医院护理部

高血压脑出血 软通道微创穿刺血肿清除术 颅内压 血脑屏障指数 疗效

江苏省卫生健康委科研项目

M2021090

2024

海军医学杂志
海军医学研究所

海军医学杂志

CSTPCD
影响因子:0.518
ISSN:1009-0754
年,卷(期):2024.45(9)