Effects of minimally invasive intracranial hematoma removal surgery on vasoactive substances,TCD parameters,and serum sCD40L,MMP-9 and HMGB-1 levels in patients with hypertensive intracerebral hemorrhage
Objective To investigate the effects of minimally invasive intracranial hematoma removal surgery on vasoactive substances,TCD parameters,and serum levels of soluble CD40 ligand(sCD40L),matrix metalloproteinase-9(MMP-9),and high mobility group protein B1(HMGB-1)in patients with hypertensive intracerebral hemorrhage.Methods Sixty patients with hypertensive intracerebral hemorrhage were collected as the study subjects and separated into control group(n=30)and study group(n=30)according to different treatment methods.The control group received small bone window intracranial hematoma removal surgery,while the study group received minimally invasive intracranial hematoma removal surgery.The vasoactive substances[endothelin(ET),vasopressin(AVP)],TCD parameters[peak systolic blood flow velocity(Vs),end diastolic blood flow velocity(Vd),mean blood flow velocity(Vm),pulsatile index(RI)]and serum sCD40L,MMP-9,and HMGB-1 levels were compared between the two groups on the 1st day before surgery,1st day,7th day,and 21st day after surgery.Results After operation 1,7 and 21 days,the serum levels of ET(F=77.469,25.806;all P＜0.001),AVP(F=252.399,68.781;allP＜0.001),sCD40L(F=121.190,70.891;all P＜0.001),MMP-9(F=140.814,265.522;all P＜0.001),HMGB-1(F=224.247,27.162;all P＜0.001)in the study group were lower than those in the control group,and the differences were statistically.Compared with preoperative surgery,1,7 and 21 d Vs(F=5.314,5.535;all P＜0.001),Vd(F=15.620,15.357;all P＜0.001),Vm(F=8.053,8.640;all P＜0.001)increased significantly in study group and control group;RI(F=30.872,29.244;all P＜0.001)significantly decreased in study group and control group,but the two groups were not statistically significant(P＞0.05).Conclusion Minimally invasive intracranial hematoma removal surgery had a good therapeutic effect on patients with hypertensive intracerebral hemorrhage,which could restore the patient's vasomotor function,reduce intracranial pressure,alleviate inflammatory reactions,and improve prognosis.
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