微骨窗入路对高血压脑出血的临床疗效细胞免疫及预后影响

摘要

Objective To observe the clinical effect,cellular immunity and prognosis of keyhole approach on patients with hypertensive intracerebral hemorrhage.Methods 108 patients with hypertensive intracerebral hemorrhage treated in this hospital from August 2014 to August 2016 were divided into two groups according to the different surgical methods,with 54 cases in each group.Patients in the observation group were treated with the keyhole approach for hematoma aspiration,while patients in the control group were given the traditional craniotomy for hematoma aspiration.The clinical effect and prognosis of patients were compared between two groups.Results The operation time for patients in the observation group (2.61±0.71)h was shorter than that in the control group (4.33±1.36)h,with the less amount of bleeding (225.42 ± 82.66)mL and higher rate hematoma (94.55 ％ ±5.68％) (P＜0.05);the level of leukocyte and C-reactive protein for patients in the observation group was lower than that in the control group (P＜0.05);NIHSS score and ADL score for patients in the observation group were better than those in the control group (P＜0.05).Conclusion The keyhole approach for hematoma aspiration can effectively remove the hematoma of hypertensive intracerebral hemorrhage,reduce the amount of bleeding,have limited effect on the cellular immunity,promote the neurological function,ability of living and improve the prognosis.%目的 观察微骨窗入路对高血压脑出血患者临床疗效、细胞免疫及预后的影响.方法 选取2014-08-2016-08于我院行手术治疗的108例高血压脑出血患者的临床资料,按手术方式不同分为2组,每组54例,观察组行微骨窗入路血肿清除术,对照组行传统骨瓣开颅血肿清除术,比较2组临床疗效及预后.结果 观察组手术时间(2.61±0.71)h较对照组(4.33±1.36)h短,出血量(225.42±82.66)mL较对照组少,血肿清除率(94.55±5.68)％较对照组高(P＜0.05);观察组白细胞、C反应蛋白水平较对照组低(P＜0.05);观察组NIHSS评分、ADL评分均优于对照组(P＜0.05).结论 微骨窗入路血肿清除术可有效清除血肿,减少出血量,对细胞免疫影响小,且可提高神经功能、生活能力,改善预后.