硬通道与软通道微创手术对高血压脑出血患者脑水肿及神经损伤的影响研究

刘乐

【摘要】 目的：探究與分析硬通道与软通道微创手术对高血压脑出血患者的脑水肿及神经损伤的影响。方法：选取2017年1月-2021年1月在本院接受治疗的高血压脑出血患者80例为研究对象。根据其接受的治疗方法不同，将其分为观察组与对照组，每组40例。对照组患者接受硬通道微创手术治疗，观察组患者接受软通道微创手术治疗，比较两组治疗效果。结果：观察组手术时间长于对照组，血肿引流时间、住院时间均短于对照组，差异均有统计学意义（P<0.05）。术前，两组GOS评分、Barthel指数、NIHSS评分、相对脑水肿体积、绝对脑水肿体积、NGF、NSE、SOD、GSH-Px及LPO比较，差异均无统计学意义（P>0.05）。术后2周，观察组的GOS评分、Barthel指数、NIHSS评分均显著优于对照组，相对脑水肿体积、绝对脑水肿体积均显著小于对照组，NGF、NSE、SOD、GSH-Px水平均高于对照组，LPO水平低于对照组，差异均有统计学意义（P<0.05）。结论：在高血压脑出血患者的治疗中应用软通道微创手术，可显著缩短手术时间及住院时间，减少脑水肿的体积，有效改善神经功能缺损的情况，减轻氧化应激损伤，临床效果理想，值得广泛应用，并适时予以推广。

【关键词】 硬通道微创手术 软通道微创手术 高血压脑出血 脑水肿 神经损伤

The Effect of Hard Channel and Soft Channel Minimally Invasive Surgery on Cerebral Oedema and Nerve Damage in Patients with Hypertensive Cerebral Haemorrhage/LIU Le. //Medical Innovation of China， 2021， 18（30）： 0-058

[Abstract] Objective： To explore and analyze the effect of hard channel and soft channel minimally invasive surgery on cerebral edema and nerve damage in patients with hypertensive intracerebral hemorrhage. Method： A total of 80 patients with hypertensive intracerebral hemorrhage who received treatment in our hospital from January 2017 to January 2021 were selected as the research objects. According to the different treatment methods， they were divided into observation group and control group， 40 cases in each group. Patients in the control group received hard channel minimally invasive surgery， patients in the observation group received soft channel minimally invasive surgery， and the treatment effects of the two groups were compared. Result： The surgery time of the observation group was longer than that of the control group， and the time of hematoma drainage and hospitalization were shorter than those of the control group， the differences were statistically significant （P<0.05）. Before surgery， there were no significant differences in GOS score， Barthel index， NIHSS score， relative cerebral edema volume， absolute cerebral edema volume， NGF， NSE， SOD， GSH-Px and LPO between two groups （P>0.05）. 2 weeks after surgery， GOS score， Barthel index and NIHSS score in the observation group were significantly better than those in the control group， and relative and absolute cerebral edema volume were significantly lower than those in the control group， NGF， NSE， SOD and GSH-Px levels were higher than those in the control group， while LPO level was lower than that in the control group， the differences were statistically significant （P<0.05）. Conclusion： The application of soft channel minimally invasive surgery in the treatment of patients with hypertensive intracerebral hemorrhage can significantly shorten the operation time and hospital stay， reduce the volume of brain edema， effectively improve the neurological deficit and reduce oxidative stress injury， the clinical effect is ideal， it is worthy of wide application and timely promotion.

[Key words] Hard channel minimally invasive surgery Soft channel minimally invasive surgery Hypertensive cerebral haemorrhage Cerebral oedema Nerve injury

First-author’s address： Dalian Central Hospital， Dalian 116021， China

doi：10.3969/j.issn.1674-4985.2021.30.013

高血压脑出血是临床常见的心脑血管疾病，主要的发病机制为血压持续升高导致患者的脑血管出现破裂，并对脑组织产生压迫[1]。该病发病急，病情进展快，在临床上以头晕头痛、嗜睡、昏迷、躁动等为主要的症状表现，具有较高的致死率及致残率[2]。高血压脑出血在临床上单纯应用内科治疗效果不甚理想，治疗后患者的神经功能状况恢复不佳。……