带光源医用吸引器+扩张套管在高血压脑出血患者中的应用
Application of medical suction device with light source and expansion sleeve to patients with hypertensive intracerebral hemorrhage
王海燕 1左毅 2陈尚军 3千超 2程光 4陈泽瑶5
作者信息
- 1. 陕西省核工业215医院:麻醉科;陕西 咸阳 712000
- 2. 陕西省核工业215医院:神经外科;陕西 咸阳 712000
- 3. 西安医学院第三附属医院神经脊柱外科;陕西 西安 710032
- 4. 空军军医大学西京医院神经外科;陕西 西安 710032
- 5. 大连大学附属新华临床学院;辽宁 大连116100
- 折叠
摘要
目的 探讨带光源医用吸引器+扩张套管在脑出血患者术中应用,对其脑脊液中细胞因子的影响.方法 选择陕西省核工业二一五医院神经外科,于2019年1月至2024年1月收治有手术指征的基底节区高血压脑出血患者107例,随机分为治疗组与对照组,两组均进行常规去骨瓣减压血肿清除手术,治疗组:使用带光源医用吸引器+专用扩张套管,在管腔内操作清除血肿.对照组:采用脑压板牵开脑组织,无影灯照明下清除血肿,观察对比两组的血肿清除率、手术时间、住院时间、GOS评分、脑脊液IL-1β、TNF-α水平及患者日常生活活动能力评分(ADL).结果 治疗组与对照组,血肿清除率基本相同,前者比后者手术时间缩短43.88 min,住院时间缩短13.26 d,前者脑脊液中IL-1β、TNF-α含量明显低于后者,患者日常生活活动能力评分(ADL)高于后者,差异均有统计学意义(P<0.05).结论 带光源医用吸引器+扩张套管,可以在良好的照明下清除血肿,减少脑组织牵拉,防止医源性损伤发生,减少患者脑脊液中IL-1β、TNF-α因子含量,减少术中及术后继发性神经损害的发生,改善患者预后.
Abstract
Objective To explore the effectiveness of a medical suction device with a light source and an expansion sleeve on cytokines in cerebrospinal fluid of patients with cerebral hemorrhage during surgery.Methods A total of 107 patients with basal ganglia hypertensive intracerebral hemorrhage with surgical indications were selected from the neurosurgery department of Shaanxi Nuclear Industry 215 Hospital from January 2019 to January 2024.The patients were randomly divided into a treatment group and a control group.Both groups underwent routine bone flap decompression and hematoma removal surgery.A medical suction device with a light source and a specialized expansion sleeve was used on the treatment group patients to remove the hematoma in the lumen,whereas for the control group patients,a pressure plate was used to pull open the brain tissue and the hematoma was cleared under shadowless lighting.The hematoma clearance rate,surgical time,hospital stay,GOS score,cerebrospinal fluid IL-1 β,TNF-α levels,and patient activities of daily living(ADL)scores were observed and compared between the two groups.Results Although the hematoma clearance rate of the treatment group was almost the same as that of the control group,the former one had used less than 43.88 minutes of the surgical time and less than 13.26 days of the hospital stay.The levels of IL-1 β and TNF-α in the cerebrospinal fluid of the former were significantly lower than those of the latter,and the patient's ADL score was higher than that of the latter,with statistical significance(P<0.05).Conclusion The medical suction device with a light source and an expansion sleeve can clear hematomas under good illumination,reduce brain tissue traction,prevent iatrogenic injury,reduce the levels of IL-1 β and TNF-α factors in the cerebrospinal fluid of patients,reduce the occurrence of secondary nerve damage during and after surgery,and improve patient prognosis.
关键词
带光源医用吸引器/基底节区脑出血/扩张套管/医源性损伤/继发神经损Key words
Medical suction device with light source/Cerebral hemorrhage in the basal ganglia area/Expansion sleeve/Iatrogenic injury/Secondary neurological damage引用本文复制引用
基金项目
陕西省社会科学基金(2021SF-274)
咸阳市重点研发计划(L2022ZDYFSF029)
中陕核工业集团公司科技攻关计划(61230301)
出版年
2024
NETL
NSTL
万方数据