海南医学院学报2017，Vol.23Issue(6)：837-840,4.DOI:10.13210/j.cnki.jhmu.20170104.001
微创颅内血肿清除术对高血压脑出血患者的治疗作用及TCD评价
Therapeutic effect of minimally invasive intracranial hematoma evacuation in the treatment of hypertensive cerebral hemorrhage and TCD evaluation
摘要
Abstract
Objective:To explore the therapeutic effect of minimally invasive intracranial hematoma evacuation in the treatment of hypertensive cerebral hemorrhage and the value of dynamic TCD monitoring in predicting the neurological function recovery.Methods:A total of 70 patients with hypertensive cerebral hemorrhage who were admitted in our hospital were included in the study and divided into the minimally invasive group and conservative group with 35 cases in each group according to different treatment protocols.The patients in the two groups were given drug conservative treatments.On this basis,the patients in the minimally invasive group were given urokinase in combined with minimally invasive hematoma puncture with YL-1 type needle.TCD was performed before treatment,1 d,5 d,10 d,and 21 d after treatment.The hematoma and edema volume was calculated.NIHSS was used to evaluate the neurological function recovery.Results:Vs,Vd,and Vm after treatment in the minimally invasive group were significantly elevated (P<0.05),while PI was significantly reduced (P<0.05).Vs,Vd,and Vm after treatment in the conservative group were reduced first and elevated later,while PI was elevated first and reduced later,and reached the lowest/peak 10d after treatment.Vs,Vd,and Vm 5 d,10 d,and 21 d after treatment in the minimally invasive group were significantly higher than those in the conservative group (P<0.05),while PI was significantly lower than that in the conservative group (P<0.05).The hematoma and edema volume after treatment in the two groups was significantly reduced (P<0.05).The hematoma and edema volume at each timing point was significantly lower than that in the conservative group (P<0.05).NIHSS score after treatment in the minimally invasive group was significantly reduced (P<0.05).NIHSS score in the conservative group was elevated first and reduced later,reached the peak 10d after treatment,and at each timing point was higher than that in the minimally invasive group (P<0.05).Conclusions:The early minimally invasive operation can significantly improve the hematoma adjacent blood flow volume in patients with hypertensive cerebral hemorrhage,and contribute to the neurological function recovery.TCD not only can be applied in the dynamic monitoring of cerebral blood flow volume in patients with hypertensive cerebral hemorrhage,but also has a certain value in evaluating the prognosis of neurological function.关键词
高血压脑出血/微创颅内血肿清除术/经颅多普勒超声/NIHSS评分Key words
Hypertensive cerebral hemorrhage/Minimally invasive intracranial hematoma evacuation/TCD/NIHSS score分类
医药卫生引用本文复制引用
张自豪,周敏,张文亮,刘叶,吴志宝,刘亮,高普,甘宁,安树章,郭宏川..微创颅内血肿清除术对高血压脑出血患者的治疗作用及TCD评价[J].海南医学院学报,2017,23(6):837-840,4.基金项目
This study was supported by Hebei Science and Technology supporting project(20160409) （20160409）
河北省科技支撑项目(20160409) （20160409）
