经锁孔入路神经内镜血肿清除术对颅脑外伤伴脑出血患者神经功能和血清SAA、谷氨酸、γ-氨基丁酸水平的影响
Effects of neuroendoscopic hematoma evacuation through keyhole approach on nerve function,serum SAA,glutamic acid and gamma-aminobutyric acid in patients with craniocerebral trauma and cerebral hemorrhage
刘甫云 1蒋胤姣 1黄燕1
作者信息
- 1. 310000 杭州,中国人民解放军联勤保障部队第九〇三医院
- 折叠
摘要
目的 探讨经锁孔入路神经内镜血肿清除术对颅脑外伤(TBI)伴脑出血(ICH)患者神经功能和血清淀粉样蛋白A(SAA)、谷氨酸、γ-氨基丁酸水平的影响.方法 选取 2020 年 4 月至 2023 年 4 月本院收治的TBI伴ICH患者 114 例,根据随机数字表法分为观察组(57 例,行经锁孔入路神经内镜血肿清除术)与对照组(57 例,行传统开颅血肿清除术).比较两组临床疗效,手术相关指标,采用NIHSS评分、Fugl-Meyer评定量表、Barthel指数分别评估患者神经功能缺损程度、平衡能力、日常生活活动能力,并检测血清SAA、谷氨酸和γ-氨基丁酸水平,记录术后并发症发生情况.结果 两组手术时间、住院时间经统计学分析差异无统计学意义(P＞0.05);与对照组比较,观察组术中出血量较少、血肿清除率较高(P＜0.05).观察组总有效率为高于对照组(P＜0.05).术后 1 个月,与对照组比较,观察组总有效率较高,NIHSS评分较低,Fugl-Meyer量表、Barthel指数评分较高(P＜0.05).术后 24 h,观察组血清SAA、谷氨酸水平低于对照组,γ-氨基丁酸水平高于对照组(P＜0.05).观察组与对照组术后并发症发生率差异无统计学意义(P＞0.05).结论 经锁孔入路神经内镜血肿清除术治疗TBI伴ICH效果显著,可显著改善患者神经功能,提高患者生活活动能力.
Abstract
Objective To explore the effects of neuroendoscopic hematoma evacuation through keyhole approach on nerve function and levels of serum amyloid A(SAA),glutamic acid and gamma-aminobutyric acid in patients with traumatic brain injury(TBI)with intracerebral hemorrhage(ICH).Methods A total of 114 patients with TBI and ICH admitted to the hospital were enrolled between April 2020 and April 2023.According to random number table method,they were divided into observation group(57 cases,neuroendoscopic hematoma evacuation through keyhole approach)and control group(57 cases,traditional craniotomy evacuation of hematoma).The clinical efficacy and surgical related indicators were compared be-tween the two groups.The NIHSS score,Fugl-Meyer assessment scale,and Barthel index were used to evaluate the degree of neurological deficit,bal-ance ability,and activities of daily living before and after operation.The serum SAA,glutamic acid and gamma-aminobutyric acid levels were detect-ed before and after operation,and the postoperative complications were recorded.Results There was no significant difference in operation time and hospitalization time between the two groups(P＞0.05).Compared with the control group,the intraoperative blood loss was less and the hematoma clear-ance rate was higher in the observation group(P＜0.05).The total effective rate of the observation group was higher,the NIHSS score was lower,and the Fugl-Meyer scale and Barthel index scores were higher(P＜0.05).At 24 h after surgery,levels of SAA and glutamic acid in observation group were lower than those in control group,while gamma-aminobutyric acid was higher than that in control group(P＜0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P＞0.05).Conclusion The curative effect of neuroendoscopic hematoma e-vacuation through keyhole approach is significant in patients with TBI and ICH,which can significantly improve nerve function and activities of daily living.
关键词
颅脑外伤/脑出血/神经内镜/血肿清除术/血清淀粉样蛋白A/谷氨酸/γ-氨基丁酸Key words
Traumatic brain injury/Intracerebral hemorrhage/Neuroendoscope/Hematoma evacuation/Serum amyloid A/Glutamic acid/Gamma-aminobutyric acid引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据