临床外科杂志 ›› 2023, Vol. 31 ›› Issue (2): 156-158.doi: 10.3969/j.issn.1005-6483.2023.02.018

• 论著 • 上一篇    下一篇

经锁孔入路手术对颅脑外伤伴脑出血病人恢复情况及D-二聚体、同型半胱氨酸水平表达的影响

  

  1. 214000 江苏无锡,联勤保障部队第904医院麻醉科(李晓玉、汤海琴、徐小琴),五官科(江庆)
  • 收稿日期:2022-04-14 修回日期:2022-04-14 接受日期:2022-04-14 出版日期:2023-02-20 发布日期:2023-02-20
  • 通讯作者: 江庆,Email:qingjiang456@163.com

Effect of hole access surgery on the recovery and expression of D-dimer and Hcy in patients with cerebral hemorrhage

  1. Department of Anesthesia ,The 904th Hospital of Wuxi Joint Logistics Support Center,Jiangsu Province,Wuxi 214000,China
  • Received:2022-04-14 Revised:2022-04-14 Accepted:2022-04-14 Online:2023-02-20 Published:2023-02-20

摘要: 目的 分析经锁孔入路手术和开颅手术对颅脑外伤伴脑出血病人恢复情况及D-二聚体、同型半胱氨酸(Hcy)水平表达的影响。方法依照随机信封法将我院2014年1月~2019年6月间收治的65例颅脑外伤伴脑出血病人分为观察组和对照组,观察组35例,对照组30例。对照组接受传统开颅血肿清除术治疗,观察组采用全麻下行经锁孔入路脑内血肿清除术;术后4周评估临床疗效,治疗前后对病人的神经功能缺损评分进行评估;术前、术后检测病人D-二聚体、Hcy水平。结果 观察组治疗总有效率高于对照组,术后观察组神经功能缺损评分、血中D-二聚体及Hcy水平低于对照组,差异有统计学意义(P<0.05)。结论 与开颅手术比较,锁孔显微术对颅脑外伤伴脑出血病人治疗后可有效改善临床疗效,降低血中D-二聚体及Hcy水平。

关键词: 开颅手术, 锁孔入路脑内血肿清除术, 颅脑外伤伴脑出血, D-二聚体, Hcy

Abstract: Objective To analyze the effect of keyhole approach and craniotomy on the recovery of patients with traumatic brain injury and cerebral hemorrhage and the expression of D-dimer and Hcy levels.Methods According to the random envelope method,65 patients with craniocerebral trauma complicated with cerebral hemorrhage admitted to our hospital from January 2014 to June 2019 were divided into observation group (n=35) and control group (n=30).The control group received traditional craniotomy hematoma evacuation,and the observation group was treated with intracerebral hematoma evacuation via keyhole approach under general anesthesia;the clinical efficacy was assessed after 4 weeks of treatment,and the neurological deficit score of the patients was assessed before and after treatment;the D-dimer and Hcy levels of the patients were measured before and after treatment.Results The total effective rate of the observation group was higher than that of the control group significantly (P<0.05);the neurological deficit score,D-dimer and Hcy in the blood of the observation group was lower than the control group significantly (P<0.05).Conclusion Compared with craniotomy,keyhole microscopy can effectively improve the clinical effect and reduce the D-dimer and Hcy level.

Key words: Craniotomy, intracerebral hematoma removal via keyhole approach, craniocerebral trauma with cerebral hemorrhage, D-dimer, Hcy

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[2] 田现钢, 杨岷, 樊纪丹. D-二聚体及C-反应蛋白与DeBakey Ⅲ型主动脉夹层动脉瘤假腔几何参数及预后的相关性分析[J]. 临床外科杂志, 2019, 27(6): 504-507.
[3] 徐亮, 刘凤英, 丁倩. Caprini评分、D-二聚体、纤维蛋白原水平在骨折后下肢深静脉血栓病人中的变化及其临床意义[J]. 临床外科杂志, 2019, 27(4): 328-330.
[4] 殷国江, 罗中兵, 黎笔熙, 宋晓阳. 膀胱与鼻咽温度监测在开颅手术中的应用[J]. 临床外科杂志, 2019, 27(10): 853-855.
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