Study on vascular endothelial function, inflammatory factors and clinical effects of ultra-early small bone flap hematoma removal on hypertensive cerebral hemorrhage patients
SHANG Cheng-sheng
Department of Neurosurgery, the Second Affiliated Hospital of Shenyang Medical College, Liaoning Province, Shenyang 110000, China
摘要目的 探讨超早期小骨瓣血肿清除术对高血压脑出血患者血管内皮功能、炎症因子及临床效果。方法 选择2017年1月～2019年12月我院收治的80 例高血压脑出血患者为研究对象，按照随机数字表法分为两组，每组各40 例。所有患者均在全身麻醉气管插管下实施手术干预，观察组行超早期（确诊后6 h 内）小骨瓣脑出血清除术，对照组则行早期（确诊后6～72 h 内）小骨瓣脑出血清除术，比较术后3 d 两组血管内皮生长能力、血管内皮功能及炎症因子指标变化；统计两组术后3 d 颅内压及脑灌注压。结果 术后3 d，观察组血管内皮生长能力中血管内皮生长因子和碱性成纤维细胞生长因子水平高于对照组，差异有统计学意义（P＜0.05）；观察组血管内皮功能指标中血管内皮素-1 水平低于对照组，差异有统计学意义（P＜0.05）；观察组的一氧化氮水平高于对照组，差异有统计学意义（P＜0.05）；观察组的炎症因子中超敏C 反应蛋白及肿瘤坏死因子- α 水平低于对照组，差异有统计学意义（P＜0.05）；观察组的颅内压低于对照组，差异有统计学意义（P＜0.05）；观察组的脑灌注压高于对照组，差异有统计学意义（P＜0.05）。结论 针对高血压脑出血患者，实施超早期小骨瓣微创血肿清除术，能有效地降低血管内皮功能与机体炎症因子，而且还能降低颅内压，提高脑灌注压，有利于改善患者预后。
Abstract：Objective To investigate the vascular endothelial function, inflammatory factors and clinical effects of ultra-early small bone flap hematoma removal on hypertensive cerebral hemorrhage patients. Methods A total of 80 cases hypertensive cerebral hemorrhage patients admitted to our hospital from January 2017 to December 2019 were selected as research objects, and they were divided into two groups according to random number table method, 40 cases in each group. All patients underwent surgical intervention under general anesthesia tracheal intubation. The observation group underwent ultra-early small bone flap cerebral hemorrhage removal, while the control group underwent early small bone flap cerebral hemorrhage removal. The changes of vascular endothelial growth ability, vascular endothelial function and inflammatory factor indexes were compared between the two groups 3 days after treatment. Intracranial pressure and cerebral perfusion pressure were counted 3 days after operation. Results On the 3 days after treatment,the levels of VEGF and bFGF in vascular endothelial growth capacity of the observation group were higher than those of the control group, the differences were statistically significant (P＜0.05); ET-1 level in vascular endothelial function index of the observation group was lower than that of the control group, the difference was statistically significant (P＜0.05); NO level of the observation was higher than that of the control group, the difference was statistically significant(P＜0.05); hs-CRP and TNF-α levels in inflammatory factors of the observation group were lower than those of the control group, the differences were statistically significant (P＜0.05); intracranial pressure of the observation group was lower than that of the control group,the difference was statistically significant (P＜0.05); and cerebral perfusion pressure of the observation was higher than that of the control group, the difference was statistically significant (P＜0.05). Conclusion For hypertensive cerebral hemorrhage patients, ultra-early minimally invasive hematoma removal with small bone flap can effectively reduce vascular endothelial function and inflammatory factors in the body, and can also reduce intracranial pressure and increase cerebral perfusion pressure, it helps improve patient prognosis.
尚成生. 超早期小骨瓣血肿清除术对高血压脑出血患者血管内皮功能、炎症因子及临床效果研究[J]. 中国当代医药, 2020, 27(28): 78-81.
SHANG Cheng-sheng. Study on vascular endothelial function, inflammatory factors and clinical effects of ultra-early small bone flap hematoma removal on hypertensive cerebral hemorrhage patients. 中国当代医药, 2020, 27(28): 78-81.
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