论文部分内容阅读
目的:探讨亚低温联合穿刺碎吸术治疗高血压脑出血的疗效及对患者血清TNF-α、IL-6、CRP水平的影响。方法:选取我院2015年2月~2016年8月收治的112例高血压脑出血患者作为研究对象,采取随机数字表将其分成两组,每组56例。两组患者均给予微创穿刺碎吸术治疗,观察组联合给予亚低温治疗,对比两组手术疗效、并发症、短期预后及手术前后不同时点血清TNF-α、IL-6、CRP水平变化情况。结果:观察组治疗总有效率为92.86%,与对照组(76.79%)相比明显上升(P<0.05)。观察组MODS、总并发症的发生率分别为0%、26.79%,均明显低于对照组(P<0.05)。观察组术后3d、7d血清TNF-α、IL-6、CRP水平逐渐下降,且均明显低于术前(P<0.01);对照组术后3d血清TNF-α、IL-6、CRP水平与术前相比无明显变化(P>0.05),术后7d则明显下降,并显著低于术前(P<0.01);观察组术后3、7d血清TNF-α、IL-6、CRP水平均明显低于同时点对照组(P<0.01)。观察组术后3个月预后良好率为80.36%,与对照组(62.50%)比较明显上升(P<0.05)。结论:亚低温联合穿刺碎吸术治疗高血压脑出血可有效减轻神经功能缺损,抑制体内炎症反应,降低病死率,疗效确切。
Objective: To investigate the therapeutic effect of mild hypothermia combined with puncture and suction on hypertensive intracerebral hemorrhage and its effect on serum TNF-α, IL-6 and CRP levels. Methods: A total of 112 patients with hypertensive intracerebral hemorrhage admitted from February 2015 to August 2016 in our hospital were enrolled in this study. Patients were divided into two groups according to a random number table, 56 cases in each group. The patients in both groups were treated with minimally invasive puncture and suction inhalation, and the observation group were treated with mild hypothermia. The curative effect, complications, short-term prognosis and the changes of serum TNF-α, IL-6 and CRP levels at different time points before and after operation were compared Happening. Results: The total effective rate of the observation group was 92.86%, which was significantly higher than that of the control group (76.79%) (P <0.05). The incidence of MODS in the observation group was 0% and 26.79% respectively, which were significantly lower than those in the control group (P <0.05). The levels of serum TNF-α, IL-6 and CRP in the observation group decreased gradually at 3d and 7d after operation, and were significantly lower than those before operation (P <0.01). The levels of TNF-α, IL-6 and CRP (P> 0.05), but decreased significantly on the 7th day after operation (P <0.01). The levels of TNF-α, IL-6 and CRP The levels were significantly lower than the control group (P <0.01). The good prognosis of the observation group was 80.36% at 3 months after operation, which was significantly higher than that of the control group (62.50%) (P <0.05). Conclusion: Mild hypothermia combined with puncture and crushing suction therapy for hypertensive intracerebral hemorrhage can effectively reduce neurological deficit, inhibit the inflammatory reaction in vivo and reduce the mortality rate, and the curative effect is definite.