检验医学与临床2025，Vol.22Issue(17)：2352-2356,5.DOI:10.3969/j.issn.1672-9455.2025.17.009
微创血肿穿刺引流术与神经内镜血肿清除术治疗高血压脑出血的临床效果比较
Comparison of the clinical effects of minimally invasive hematoma puncture and drainage and neuroendoscopic hematoma evacuation in the treatment of hypertensive cerebral hemorrhage
摘要
Abstract
Objective To compare the effect of minimally invasive hematoma puncture and drainage and neuroendoscopic hematoma removal in the treatment of hypertensive intracerebral hemorrhage(HICH).Methods A total of 82 patients with HICH admitted to the First Hospital of Fangshan District of Beijing from January 2022 to March 2024 were selected as the research objects.According to the treatment methods,the patients who underwent minimally invasive hematoma puncture and drainage were set as group A(41 ca-ses),and the patients who underwent neuroendoscopic hematoma removal were set as group B(41 cases).The neurological function[National Institutes of Health Stroke Scale(NIHSS)score],renin-angiotensin system[serum al-dosterone(ALD),renin activity(PRA)and angiotensin Ⅱ(Ang Ⅱ)levels],inflammatory response[serum Creactive protein(CRP)and interleukin(IL)-6 levels],neurotransmitter[serum 5-hydroxytryptamine(5-HT)and norepi-nephrine(NE)levels]and prognosis were compared between the two groups before and 7 d after surgery.Re-sults There was no significant difference in the levels of ALD,PRA,Ang Ⅱ,CRP,IL-6,5-HT,NE,NIHSS and SSS scores between the two groups before operation(P＞0.05).At 7 d after operation,the ALD,PRA,Ang Ⅱ,CRP,IL-6 levels and NIHSS score of the two groups were lower than those before operation,5-HT,NE levels and SSS score were higher than those before operation,and the ALD,PRA,Ang Ⅱ,CRP,IL-6 levels and NIHSS score of group B were lower than those of group A,the levels of 5-HT,NE and SSS score were significantly higher than those in group A,with statistically significant differences(P＜0.05).The operation time and postoperative hospital stay in group A were shorter than those in group B,the intraoperative blood loss and treatment cost in group A were less than those in group B,the hematoma clearance rate was lower than that in group B,the differences were statistically significant(P＜0.05).There was no significant differ-ence in the incidence of complications between two groups(P＞0.05).There was statistically significant differ-ence in the prognostic grading between the two groups(P＜0.05).Conclusion Neuroendoscopic hematoma evacua-tion is more effective in removing hematoma,with better postoperative neurological function recovery and better prognosis,but it has greater trauma,high cost and slow postoperative recovery.Minimally invasive hematoma puncture and drainage has the advantages of small trauma,short operation time,fast postoperative recovery and low cost.However,the recovery of neurological function is limited after operation,and the appropriate surgical method should be selected according to the clinical situation of the patient.关键词
微创血肿穿刺引流术/神经内镜血肿清除术/高血压脑出血/神经功能/预后Key words
minimally invasive hematoma puncture and drainage/neuroendoscopic hematoma evacua-tion/hypertensive cerebral hemorrhage/neurological function/prognosis分类
医药卫生引用本文复制引用
李志强,李剑,梁建锋,朱振云,刘云..微创血肿穿刺引流术与神经内镜血肿清除术治疗高血压脑出血的临床效果比较[J].检验医学与临床,2025,22(17):2352-2356,5.基金项目
首都卫生发展科研专项(2019-4021-06). （2019-4021-06）
