中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2011年
1期
31-33
,共3页
方启龙%金成胜%何永清%张金海%周仲浩%芮亦峰%李军
方啟龍%金成勝%何永清%張金海%週仲浩%芮亦峰%李軍
방계룡%금성성%하영청%장금해%주중호%예역봉%리군
外科手术,微创性%颅内出血,高血压性%血脑屏障
外科手術,微創性%顱內齣血,高血壓性%血腦屏障
외과수술,미창성%로내출혈,고혈압성%혈뇌병장
Surgical procedured,minimally invasive%Intracranial hemorrhage,hypertensive%Blood-brain barrier
目的 探讨不同时间颅内血肿微创清除术对高血压脑出血患者血脑屏障指数(BBB)、血清髓鞘碱性蛋白(MBP)及预后日常生活能力评分(ADL)的影响. 方法观察时间≤3.0 h 30例,3.1～8.0 h 32例,8.1～24.0 h 28例,＞24.0 h 22 例,对照分析其BBB、MBP及ADL的变化.结果 ≤3.0 h、3.1～8.0 h微创血肿清除术组BBB和MBP[(6.57±0.69)×10 3和(3.12±0.40)μg/L、(7.37±1.29)×10 3和(3.25±0.60)μg/L]均明显低于8.1～24.0 h、＞24.0 h组[(12.02±1.51)×10-3和(4.60±0.48)μg/L、(14.68±2.07)×10-3和(5.88±0.64)μg/L,Q＞13.8,P＜0.05];≤3.0 h,3.1～8.0 h微创血肿清除术组[(2.60±1.07)分、(3.06±0.91)分]均明显高于8.1～24.0h、＞24.0 h组[(4.00±0.67)分、(3.68±1.32)分,Q＞3.1,P＜0.05]. 结论≤8.0 h实施微创血肿清除术可减轻高血压脑出血患者细胞毒性对血脑屏障的损伤,从而减轻脑水肿,提高患者的生存质量.
目的 探討不同時間顱內血腫微創清除術對高血壓腦齣血患者血腦屏障指數(BBB)、血清髓鞘堿性蛋白(MBP)及預後日常生活能力評分(ADL)的影響. 方法觀察時間≤3.0 h 30例,3.1～8.0 h 32例,8.1～24.0 h 28例,＞24.0 h 22 例,對照分析其BBB、MBP及ADL的變化.結果 ≤3.0 h、3.1～8.0 h微創血腫清除術組BBB和MBP[(6.57±0.69)×10 3和(3.12±0.40)μg/L、(7.37±1.29)×10 3和(3.25±0.60)μg/L]均明顯低于8.1～24.0 h、＞24.0 h組[(12.02±1.51)×10-3和(4.60±0.48)μg/L、(14.68±2.07)×10-3和(5.88±0.64)μg/L,Q＞13.8,P＜0.05];≤3.0 h,3.1～8.0 h微創血腫清除術組[(2.60±1.07)分、(3.06±0.91)分]均明顯高于8.1～24.0h、＞24.0 h組[(4.00±0.67)分、(3.68±1.32)分,Q＞3.1,P＜0.05]. 結論≤8.0 h實施微創血腫清除術可減輕高血壓腦齣血患者細胞毒性對血腦屏障的損傷,從而減輕腦水腫,提高患者的生存質量.
목적 탐토불동시간로내혈종미창청제술대고혈압뇌출혈환자혈뇌병장지수(BBB)、혈청수초감성단백(MBP)급예후일상생활능력평분(ADL)적영향. 방법관찰시간≤3.0 h 30례,3.1～8.0 h 32례,8.1～24.0 h 28례,＞24.0 h 22 례,대조분석기BBB、MBP급ADL적변화.결과 ≤3.0 h、3.1～8.0 h미창혈종청제술조BBB화MBP[(6.57±0.69)×10 3화(3.12±0.40)μg/L、(7.37±1.29)×10 3화(3.25±0.60)μg/L]균명현저우8.1～24.0 h、＞24.0 h조[(12.02±1.51)×10-3화(4.60±0.48)μg/L、(14.68±2.07)×10-3화(5.88±0.64)μg/L,Q＞13.8,P＜0.05];≤3.0 h,3.1～8.0 h미창혈종청제술조[(2.60±1.07)분、(3.06±0.91)분]균명현고우8.1～24.0h、＞24.0 h조[(4.00±0.67)분、(3.68±1.32)분,Q＞3.1,P＜0.05]. 결론≤8.0 h실시미창혈종청제술가감경고혈압뇌출혈환자세포독성대혈뇌병장적손상,종이감경뇌수종,제고환자적생존질량.
Objective To explore the effects of minimally invasive removal of intracranial hematoma on blood-brain barrier (BBB) index, serum myelin basic protein (MBP) and activity of daily living (ADL) in hypertensive patients with cerebral hemorrhage.Methods Through observing 30cases operated within 3.0 hours, 32 case operated between 3. 1-8. 0 hours, 28 cases operated between 8. 1 to 24.0 hours and 22 cases operated over 24 hours, the changes of BBB index, serum MBP and ADL were analyzed. Results The BBB index and serum MBP were significantly lower in patients operated within 8. 0 hours than in patients operated over 8. 1 hours [≤3.0 hours group:(6.57±0.69)×10-3 and (3. 12±0.40)μg/L;3. 1-8.0 hours group: (7. 37±1.29)×10-3 and (3.25±0.60)μg/L;8. 1-2.0 hours group: ( 12. 02± 1.51 ) × 10 3 and (4. 60±0. 48)μg/L;over 24.0 hours group: ( 14. 68±2.07)×10-3 and (5.88±0.64)μg/L,Q＞13.8,P＜0. 05]. And the ADL was lower in patients operated within 8. 0 hours than in patients operated over 8. 1 hours [≤3.0 hours group: (2. 60± 1.07)scores; 3.1-8.0 hours group: (3. 06±0. 91 )scores;8. 1-24.0 hours group: (4.00±0.67) scores;over 24.0 hours group:(3.68±1.32)scores,Q＞3. 1,P＜0.05].Conclusions The minimally invasive surgery of intracranial hematoma within 8.0 hours can mitigate the cytotoxicity-damaged BBB so as to lighten brain edema and improve the patients quality of life.
