杨军;王小峰;

• 1:新乡市第二人民医院
• 2:渭南市中心医院

摘要(Abstract)：

目的比较显微与神经内镜手术治疗基底节区高血压脑出血的疗效及安全性。方法选择2017-02—2019-07在新乡市第二人民医院接受治疗的基底节区高血压脑出血患者86例,采用随机数字表法分为对照组与观察组,每组43例。对照组患者接受显微手术治疗,观察组患者接受神经内镜治疗。比较2组患者的疗效及安全性。结果观察组手术时间、术中止血时间、住院时间短于对照组(P<0.05),术中出血量少于对照组(P<0.05)。观察组血肿清除率、术后GCS评分、术后GOS评分高于对照组(P<0.05)。观察组患者切口感染、颅内血肿、颅内感染、肺部感染等总发生率4.65%,低于对照组的27.91%(P<0.05)。观察组血肿复发率为0(0/43),低于对照组的13.95%(6/43)(P<0.05)。2组患者治疗后1周的NIHSS评分低于治疗前,观察组治疗后1周的NIHSS评分为(7.09±1.93)分,低于对照组的(11.98±2.79)分,差异有统计学意义(P<0.05)。结论神经内镜手术治疗高血压基底节区脑出血的效果显著,手术时间和住院时间明显缩短,术中出血量明显减少,血肿清除率明显提高,术后并发症发生率明显降低,有助于改善患者预后,且安全性较高。

关键词(KeyWords)： 神经内镜手术;显微手术;基底节区;高血压脑出血;安全性

Abstract:

Keywords:

基金项目(Foundation): 渭南市科技计划项目(编号:2019-ZDYF-SFCX-13)

作者(Authors): 杨军;王小峰;

参考文献(References)：

• [1] BOWES A L,JOSH K R,WILLIAM J D,et al.Neuroendoscopic surgery in children:does age at intervention influence safety and efficacy?A single-center experience[J].J Neurosurg Pediatr,2017,20(4):1-5.DOI:10.3171/2017.4.PEDS16488.
• [2] CHOO J,TAKEUCHI K,NAGATA Y,et al.Neuro-endoscopic cylinder surgery and 5-aminolevulinic acid (5-ALA) photodynamic diagnosis of deep-seated intracranial lesions[J].World Neurosurg,2018,116(12):287-293.DOI:10.1016/j.wneu.2018.03.112.
• [3] SHETTY K,SHETTY R,RAO P,et al.Comparison of Plasma Levels of Renin,Vasopressin and Atrial Natriuretic Peptide in Hypertensive Amlodipine Induced Pedal Oedema,Non-Oedema and Cilnidipine Treated Patients[J].J Clin Diagn Res,2017,11(6):FC05-FC07.DOI:10.7860/JCDR/2017/25097.9958.
• [4] LI N Y,ZHANG P P,DING H,et al.A5504 Comparison of the effects of valsartan and amlodipine on the characteristics of ambulatory blood pressure in hypertensive patients[J].J Hypertension,2018,36(8):e170-e174.DOI:10.1097/01.hjh.0000548691.50551.b8.
• [5] MAO L L,YUAN H,WANG W W,et al.Adoptive Regulatory T-cell Therapy Attenuates Perihematomal Inflammation in a Mouse Model of Experimental Intracerebral Hemorrhage[J].Cell Mol Neurobiol,2017,37(5):919-929.DOI:10.1007/s10571-016-0429-1.
• [6] SUN X,LUO L,ZHAO X Q,et al.The neutrophil-to-lymphocyte ratio on admission is a good predictor for all-cause mortality in hypertensive patients over 80 years of age[J].BMC Cardiovasc Disord,2017,17(1):167-169.DOI:10.1186/s12872-017-0595-1.
• [7] MARCO P,GREGOIRE B,PANAGIOTIS F,et al.Distribution of lacunes in cerebral amyloid angiopathy and hypertensive small vessel disease[J].Neurology,2017,88(23):2162-2167.DOI:10.1212/WNL.0000000000004007.
• [8] 查昀,王煜,郑俊,等.经侧裂-岛叶入路显微手术治疗基底节区高血压脑出血[J].中国实用神经疾病杂志,2017,20(22):44-47.DOI:CNKI:SUN:HNSJ.0.2017-22-013.
• [9] LISA A D.Hypertensive Disorders in Pregnancy and Future Maternal Cardiovascular Disease:The Challenges of Looking Beyond First Pregnancy[J].Paediatr Perinat Epidemiol,2017,31(5):422-423.DOI:10.1111/ppe.12398.
• [10] BELOVA L A,MASHIN V V,KOLO O Y,et al.The influence of Cytoflavin therapy on the cerebral hemodynamics in patients with various stages of hypertensive disease[J].Zh Nevrol Psikhiatr Im S S Korsakova,2017,117(7):28-30.DOI:10.17116/jnevro20171177128-35.
• [11] THAIS O F,JHULI K A,LUIZ G M,et al.A Single Resistance Exercise Session Improves Aortic Endothelial Function in Hypertensive Rats[J].Arquivos Brasileiros De Cardiologia,2017,108(3):228-230.DOI:10.5935/abc.20170023,
• [12] KADRIYE G Y,UQUR C,?AGRI Y,et al.A Novel Marker of Impaired Aortic Elasticity in Never Treated Hypertensive Patients:Monocyte/High-Density Lipoprotein Cholesterol Ratio[J].Acta Cardiologica Sinica,2017,33(1):41-49.DOI:10.6515/ACS20160427A.
• [13] MA M C J,PETTUS J M,JAKO J A,et al.Contribution of independent and pleiotropic genetic effects in the metabolic syndrome in a hypertensive rat[J].PLoS One,2017,12(8):e0182650.DOI:10.1371/journal.pone.0182650.
• [14] SHYAN Y C,ANNAS S,NOR F S,et al.Blood-pressure lowering efficacy of winged bean seed hydrolysate in spontaneously hypertensive rats,peptide characterization and a toxicity study in Sprague-Dawley rats[J].Food Function,2018,9(12):368-374.DOI:10.1039/C7FO01769C.
• [15] HAN Q,ZHENG L,HAN C,et al.Comparative Efficacy of Antihypertensive Agents in Salt-Sensitive Hypertensive Patients:A Network Meta-Analysis[J].Am J Hypertension,2018,31(7):225-227.DOI:10.1093/ajh/hpy027.
• [16] KEHIN A U,ADETO B O,THEO I U,et al.Effect of Calcium Channel Blockers on Gingival Tissues in Hypertensive Patients in Lagos,Nigeria:A Pilot Study[J].Contemp Clin Dent,2017,8(4):565-570.DOI:10.4103/ccd.ccd_536_17.
• [17] CAITRIN W M,OYUNB M,ANA C C,et al.Genetic Variants Influencing Plasma Renin Activity in Hypertensive Patients From the PEAR Study (Pharmacogenomic Evaluation of Antihypertensive Responses)[J].Circ Genom Precis Med,2018,11(4):e001854.DOI:10.1161/CIRCGEN.117.001854.
• [18] SHARON V,ANNE S S,DORIEN L,et al.Development of a biophysical screening model for gestational hypertensive diseases[J].J Biomed Sci,2019,26(1):188-193.DOI:10.1186/s12929-019-0530-0.