CAJ | 학술논문

目的：探讨微创碎吸术手术时机对高血压脑出血患者血清IL-6、TNF-α水平的影响。方法将220例高血压脑出血患者随机分为观察组及对照组各110例。2组患者均常规给予脱水降颅内压、控制血糖和血压及神经营养支持等治疗。观察组患者脑出血6h内进行微创碎吸术手术，对照组患者脑出血6～24h内进行微创碎吸术手术。检测2组患者手术前后血清IL-6及TNF-α的含量水平，并比较2组的临床疗效。结果观察组总有效率为91．82％高于对照组的74．55％，差异有统计学意义（P＜0．05）。治疗前2组血清IL-6与TNF-α水平差异均无统计学意义（P＞0．05），治疗后，2组患者血清IL-6、TNF-α水平均显著低于治疗前，且随着治疗时间的延长，血清IL-6与TNF-α水平逐渐降低；治疗2、3、5、7d时观察组患者血清IL-6与TNF-α水平均低于对照组，差异均有统计学意义（ P＜0．05）。结论脑出血6h内进行微创碎吸术手术可提高高血压脑出血治疗有效率。
목적：탐토미창쇄흡술수술시궤대고혈압뇌출혈환자혈청IL-6、TNF-α수평적영향。방법장220례고혈압뇌출혈환자수궤분위관찰조급대조조각110례。2조환자균상규급여탈수강로내압、공제혈당화혈압급신경영양지지등치료。관찰조환자뇌출혈6h내진행미창쇄흡술수술，대조조환자뇌출혈6～24h내진행미창쇄흡술수술。검측2조환자수술전후혈청IL-6급TNF-α적함량수평，병비교2조적림상료효。결과관찰조총유효솔위91．82％고우대조조적74．55％，차이유통계학의의（P＜0．05）。치료전2조혈청IL-6여TNF-α수평차이균무통계학의의（P＞0．05），치료후，2조환자혈청IL-6、TNF-α수평균현저저우치료전，차수착치료시간적연장，혈청IL-6여TNF-α수평축점강저；치료2、3、5、7d시관찰조환자혈청IL-6여TNF-α수평균저우대조조，차이균유통계학의의（ P＜0．05）。결론뇌출혈6h내진행미창쇄흡술수술가제고고혈압뇌출혈치료유효솔。
Objective To explore the influence of minimally invasive aspiration operation time on the clinical effect , serum IL-6,TNF-αlevel in patients with hypertensive cerebral hemorrhage .Methods 220 patients with hypertensive cerebral hemorrhage were randomly divided into observation group and control group ,110 cases of each .All patients were treated by diu-resis dehydration ,blood sugar and blood pressure control ,neurotrophic therapy and other symptomatic treatment .The observa-tion group was received minimally invasive aspiration operation in 6 hours after hypertensive cerebral hemorrhage , while the control group was treated after hypertensive cerebral hemorrhage 6 hours but in 24 hours.The serum level of IL-6 and TNF-α, therapy effect of two groups were tested and compared the differences .Results Total effective rate of observation group (91.82%) was higher than that of the control group (74.55%),the difference was statistically significant (P<0.05).Before the treatment,the difference between the 2 groups of serum IL-6 and TNF-αlevel had no statistical significance (P>0.05). After treatment ,the serum levels of two groups were significantly lower than that before treatment , and with the extension of treatment time,serum IL-6 and TNF-αlevels decreased gradually .The serum IL-6 and TNF-αlevels in treatment of 2, 3, 5,7d were lower than the control group ,the differences were statistically significant (P<0.05).Conclusion Taking the minimally invasive aspiration operation within 6 hours after hypertensive cerebral hemorrhage can improve the effectiveness .