中国实用神经疾病杂志2024，Vol.27Issue(9)：1146-1151,6.DOI:10.12083/SYSJ.230429
立体定向微创术对老年自发性丘脑出血患者术后再出血及近期预后的影响
Effect of stereotactic minimally invasive surgery on postoperative rebleeding and recent prognosis in elderly patients with spontaneous thalamic hemorrhage
摘要
Abstract
Objective To investigate the value of stereotactic minimally invasive surgery in the treatment of elderly patients with spontaneous thalamic hemorrhage.Methods Ninety-nine patients with spontaneous thalamic hemorrhage admitted to Ziyang Hospital of Traditional Chinese Medicine from April 2020 to May 2022 were selected and were randomly divided into two groups.The control group(n=49)received conservative drug therapy,and the study group(n=50)received stereotactic microtrauma therapy.Hematoma volume,fraction of anisotropy(FA)value,serum inflammatory factors(C-reactive protein(CRP),matrix metalloproteinase-9(MMP-9),tumor necrosis factor α(TNF-α))and prognostic factors(nuclear factor-κ B p65(NF-κ B p65),platelet-derived growth faction-D(PDGF-D),neurite outgrowth inhibitor A(Nogo-A))levels,neurological function(NIHSS score),degree of disturbance of consciousness(GCS score),ability of daily living(MBI score),complications,length of hospital stay were compared between the two groups before and after treatment.All the patients were followed up for 3 months after discharge.The prognosis of the two groups was statistically compared.Results One and two weeks after treatment,the volume of hematoma in the study group was lower than that in the control group,and the FA value was higher than that in the control group(P<0.05).The levels of CRP,MMP-9,TNF-α,NF-κB p65,PDGF-D and Nogo-A in the study group were lower than those in the control group 1 month and 3 months after treatment(P<0.05).One month and three months after treatment,the NIHSS score of the research group was lower than that of the control group,and the GCS and MBI scores were higher than those of the control group(P<0.05).The incidence of bleeding,pulmonary infection and lower limb venous thrombosis in the study group was lower than those in the control group,and the length of hospitalization was shorter than that in the control group(P<0.05).The good prognosis rate of the study group(76.00%)was higher than that of the control group(55.10%,P<0.05).Conclusion Stereotactic minimally invasive surgery can improve the hematoma removal effect in elderly patients with spontaneous thalamic hemorrhage,reduce the inflammatory reaction,contribute to early neurological function recovery,reduce the degree of consciousness disorder,shorten the hospitalization time,and enhance the ability of daily activities,and it can improve the safety of the treatment,and improve the prognosis.关键词
丘脑出血/立体定向/微创术/炎性因子/神经功能/预后Key words
Thalamic hemorrhage/Stereotactic orientation/Minimally invasive surgery/Inflammatory factors/Neural function/Prognosis分类
医药卫生引用本文复制引用
孙会英,冉小平,王维波,邓达,吴波,尹泽钢..立体定向微创术对老年自发性丘脑出血患者术后再出血及近期预后的影响[J].中国实用神经疾病杂志,2024,27(9):1146-1151,6.基金项目
四川省重症医学(国瑞)专项科研课题(编号:18PJ015) （国瑞）
