基于卡诺模型的阶段性康复护理对脑梗死后偏瘫患者康复依从性、心理状态、自我管理能力、神经功能、肢体功能、日常生活能力的影响

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目的 探究基于卡诺模型的阶段性康复护理对脑梗死后偏瘫患者心理状态及肢体功能的影响。 方法 本研究回顾性纳入2024年3月—2025年3月我院收治的86例脑梗死后偏瘫患者,并按护理方案差异将其均分为观察组与对照组,每组各43例。对照组采用采用常规康复护理方案,观察组在此基础上采用基于卡诺模型的阶段性康复护理。干预后,统计对比两组心理状态[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)]、神经功能[美国国立卫生研究院卒中量表(NIHSS)]、自我管理能力[中文版脑卒中自我管理能力量表(SSSMQ)]、日常生活能力[改良Barthel指数(MBI)]、肢体功能[Fugl-Meyer运动功能积分法(FMA)]、康复依从性、护理满意度。结果 干预后,观察组HAMA、HAMD评分均显著低于对照组,FMA各维度及总分均显著高于对照组(P<0.05);干预后,观察组NIHSS评分低于对照着,SSSMQ、MBI评分高于对照组(P<0.05);观察组治疗总依从率显著高于对照组,护理总满意度显著高于对照组(P<0.05)。结论 基于卡诺模型的阶段性康复护理应用于脑梗死后偏瘫患者,能改善其心理状态,提高康复依从性及自我管理能力,有助于改善患者神经功能,增强肢体功能,恢复生活活动能力,提高护理满意度。

养血清脑颗粒联合银杏叶提取物注射液对脑梗死恢复期患者神经功能及认知功能的影响

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目的 探讨养血清脑颗粒联合银杏叶提取物注射液对脑梗死(CI)恢复期患者神经功能及认知功能的影响。方法 选取我院2024年7月-2025年11月收治的CI恢复期患者120例,按随机数字表法分2组,各组均60例;对照组予银杏叶提取物注射液治疗,治疗组基于对照组予养血清脑颗粒治疗,治疗周期均2周;对比2组疗效、神经功能、脑动脉血流速度、炎症指标、血液流变学指标、认知功能及不良反应。结果 治疗组总治疗有效率(95.00%)较对照组(81.67%)高,治疗后美国国立卫生研究院卒中量表(NIHSS)评分较对照组低(P<0.05);治疗组治疗后脑动脉平均血流速度(Vm)较对照组高,搏动指数(PI)、阻力指数(RI)、C反应蛋白(CRP)、同型半胱氨酸(Hcy)水平、血浆黏度、纤维蛋白原(FIB)水平、血小板最大聚集率水平较对照组低(P<0.05);治疗组治疗后简明精神状态检查量表(MMSE)评分较对照组高(P<0.05);组间不良反应相比无统计学差异(P>0.05)。结论 养血清脑颗粒联合银杏叶提取物注射液治疗CI恢复期患者效果较好,可减轻神经功能缺损,提高脑动脉血流速度,降低炎症反应,调节血液流变学,改善认知功能。

基于潜类别增长模型的脑出血患者神经功能恢复轨迹及预后

Neurological recovery trajectory and prognosis of patients with cerebral hemorrhage based on latent class growth model

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【摘要】目的:基于潜类别增长模型(LCGM)探讨脑出血患者神经功能恢复轨迹及不同轨迹对预后的影响。方法:回顾性采集360例自发性脑出血患者(2023年6月~2025年6月)的临床资料及神经功能评分[美国国立卫生研究院卒中量表(NIHSS)],并采用LCGM识别神经功能恢复轨迹的潜在类别,分析影响恢复不良型轨迹的危险因素,对比不同轨迹的预后情况[改良Rankin量表(mRS)、格拉斯哥预后评分(GOS)]。结果:LCGM模型拟合结果显示,3类轨迹为最优拟合模型,可将360例自发性脑出血患者分为快速恢复型139例(38.61%)、稳定恢复型154例(42.78%)、恢复不良型67例(18.61%);入院格拉斯哥昏迷量表(GCS)评分、初始NIHSS评分、机械通气、血管活性药物使用及血肿体积是神经功能恢复不良的独立影响因素(P<0.05);预后方面,三组患者mRS、GOS评分存在显著差异(P<0.05)。结论:基于LCGM可有效识别脑出血患者神经功能恢复的异质性轨迹,同时还能明确影响患者神经功能修复的独立危险因素及不同神经功能恢复轨迹与预后的关联。
Abstract Objective: To explore the trajectory of neurological recovery in patients with cerebral hemorrhage and the impact of different trajectories on prognosis based on latent class growth model (LCGM). Methods: The clinical data and neurological function scores [National Institutes of Health Stroke Scale (NIHSS)] of 360 patients with spontaneous cerebral hemorrhage (June 2023 to June 2025) were retrospectively collected, and LCGM was used to identify potential categories of neurological recovery trajectories, analyze risk factors affecting poor recovery trajectories, and compare the prognosis of different trajectories [modified Rankin Scale (mRS), Glasgow Outcome Score (GOS)]. Results: The LCGM model fitting results showed that the three types of trajectories were the optimal fitting model, and 360 patients with spontaneous cerebral hemorrhage could be divided into 139 cases (38.61%) of rapid recovery type, 154 cases (42.78%) of stable recovery type, and 67 cases (18.61%) of poor recovery type; admission to Glasgow Coma Scale (GCS) score, initial NIHSS score, mechanical ventilation, use of vasoactive drugs and hematoma volume are independent influencing factors of poor neurological recovery (P<0.05); in terms of prognosis, there were significant differences in mRS and GOS scores among the three groups of patients (P<0.05).Conclusion: Based on LCGM, it is possible to effectively identify the heterogeneous trajectories of neurological function recovery in patients with intracerebral hemorrhage (ICH), while also identifying independent risk factors influencing neurological function repair and establishing associations between different recovery trajectories and prognosis.

血脑屏障标志物与帕金森病患者神经功能损伤程度及不良预后的关联研究

Study on the correlation between blood-brain barrier markers and the degree of neurological damage and poor prognosis in Parkinson's disease patients

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目的:分析血脑屏障标志物闭合蛋白(Occludin,OCLN)、密封蛋白-5(Claudin-5,CLDN5)与帕金森病(PD)患者神经功能损伤程度及不良预后的关联。方法:研究对象选择2024年6月~2025年6月就诊于我院的180例PD患者,及同期接受检查的180例健康志愿者,将其分别列为病例组、对照组,比较两组OCLN、CLDN5间差异。依据病情严重程度不同,将PD患者分别列为早期组(50例)、中期组(65例)和晚期组(65例),比较三组患者OCLN、CLDN5,神经损伤标志物间差异,分析晚期组患者OCLN、CLDN5与神经损伤标志物的相关性。统计入组患者不良预后发生情况,比较不同预后患者OCLN、CLDN5及神经损伤标志物间差异,分析PD患者预后影响因素,验证OCLN、CLDN5对PD患者不良预后的预测效能。结果:病例组的外周血OCLN、CLDN5均高于对照组(t=50.450,51.670;P<0.05)。晚期组外周血OCLN、CLDN5、神经元特异性烯醇化酶(NSE)、泛素羧基末端水解酶L1(UCH-L1)、神经丝轻链蛋白(NfL)、胶质纤维酸性蛋白(GFAP)均高于中期组、早期组(F=280.611,378.453,82.254,122.413,185.272,257.733;P<0.05)。晚期组的OCLN、CLDN5均与NSE、UCH-L1、NfL、GFAP正相关(r=0.411,0.457,0.505,0.494,0.465,0.425,0.491,0.503;P<0.05)。180例PD患者的不良预后发生率为28.89%(52/180)。预后不良组的外周血OCLN、CLDN5、NSE、UCH-L1、NfL、GFAP均高于预后良好组(t=17.096,14.405,7.632,6.903,11.695,10.702;P<0.05)。Logistic多因素回归分析结果显示,外周血OCLN、CLDN5、NfL、GFAP高表达为PD患者发生不良预后的危险因素。经ROC检验,外周血OCLN、CLDN5联合检测对于PD不良预后的预测AUC高于外周血OCLN、CLDN5单独检测(DeLong检验,P<0.05)。结论:外周血OCLN、CLDN5可随PD患者神经损伤程度加剧而不断升高,联合检测外周血OCLN、CLDN5或可作为预测患者不良预后的重要辅助手段。
Objective:To analysis of the association between blood-brain barrier markers Occludin (OCLN), Claudin-5 (CLDN5) and the degree of neurological damage and poor prognosis in PD patients.Methods:The research subjects selected 180 PD patients who visited our hospital from June 2024 to June 2025, as well as 180 healthy volunteers who underwent examinations during the same period. They were divided into a case group and a control group, and the differences between the two groups in terms of OPLN and CLDN5 were compared. According to the severity of the disease, PD patients were divided into early group (50 cases), middle group (65 cases), and late group (65 cases). The differences in OCLN, CLDN5, and nerve injury markers among the three groups of patients were compared, and the correlation between OCLN, CLDN5, and nerve injury markers in the late group of patients was analyzed. Statistically analyze the occurrence of poor prognosis in enrolled patients, compare the differences in OCLN, CLDN5, and nerve injury markers among patients with different prognoses, analyze the factors affecting the prognosis of PD patients, and verify the predictive power of OCLN and CLDN5 for poor prognosis in PD patients.Results:The peripheral blood levels of OCLN and CLDN5 in the case group were higher than the control group (t=50.450,51.670; P<0.05). The levels of OCLN, CLDN5 NSE,UCH-L1,NfL, and GFAP in peripheral blood of the late stage group were higher than those of the mid stage and early stage groups (F=280.611,378.453,82.254,122.413,185.272,257.733; P<0.05). The OCLN and CLDN5 in the late stage group were positively correlated with NSE, UCH-L1, NfL, and GFAP (r=0.411,0.457,0.505,0.494,0.465,0.425,0.491,0.503; P<0.05). The incidence of poor prognosis in 180 PD patients was 28.89% (52/180). The peripheral blood levels of OCLN, CLDN5, NSE, UCH-L1, NfL, and GFAP in the poor prognosis group were higher than those in the good prognosis group (t=17.096,14.405,7.632,6.903,11.695,10.702; P<0.05). The results of logistic multiple regression analysis showed that high expression of peripheral blood OCLN, CLDN5, NfL, and GFAP were risk factors for poor prognosis in PD patients. According to ROC test, the combined detection of peripheral blood OCLN and CLDN5 has a higher AUC for predicting poor prognosis of PD than the detection of peripheral blood OCLN and CLDN5 alone (DeLong test, P<0.05).Conclusion:Peripheral blood OCLN and CLDN5 can exacerbate and continuously increase the degree of nerve damage in PD patients. Combined detection of peripheral blood OCLN and CLDN5 may serve as an important auxiliary tool for predicting poor prognosis in patients.
论著

脊髓损伤神经功能评估系统的优化和临床应用效果分析

Optimized design and clinical efficacy analysis of neural function evaluation system for spinal cord injury

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目的 优化纸质版脊髓损伤神经功能评估系统, 探讨其在脊柱脊髓损伤患者临床管理中的实际应用效果。方法 广泛检索国内外关于脊柱脊髓损伤患者神经运动功能评估的文献, 结合课题组成员的临床经验, 初步筛选出神经运动功能评估的关键项目。通过两轮德尔菲专家函询, 确定评估项目内容, 对纸质版脊髓损伤神经功能评估系统进行优化, 并进行临床应用验证。选取2021年8月1日—2023年5月31日在广州市第一人民医院脊柱外科住院的120例脊柱脊髓疾病患者作为研究对象, 随机分为观察组和对照组。对比两组在应用优化前后评估系统的神经功能评估准确性、评估所需时间以及临床应用便捷性等方面的差异。结果 观察组的评估准确性显著高于对照组,错评率由20.3%降至4.7%,漏评率由32.0%降至5.0%; 此外,优化后的评估系统显著缩短了评估时间,平均减少6.0 min, 有效提升了评估效率。结论 优化后的脊髓损伤神经功能评估系统显著提高了评估的准确性和效率, 有效减少了主观误差。
Objective To refine and optimize the paper-based assessment tool for evaluating neurological function in spinal cord injury patients, and to explore its impact on clinical practice.Methods A comprehensive review of existing literature on neuromotor function assessment in spinal cord injury patients was conducted, complemented by discussions among members of this study.This led to the integration of a preliminary evaluation framework.Subsequently, a two-round Delphi consensus process involving experts was undertaken to finalize the content of the assessment project.Based on this, a paper-based evaluation system was developed and converted into an electronic format by computer professionals.This system was then tested in a clinical setting, where it was administered to 120 spinal cord injury patients at the Spine Surgery Department of Guangzhou First People’s Hospital between 1 August 2021 and 31 May 2023.Patients were randomly assigned to either an experimental group or a control group, allowing for a comparison of accuracy, efficiency, and convenience in clinical application.Results The experimental group demonstrated a notable improvement in assessment accuracy over the control group, with a significant reduction in error rate from 20.3% to 4.7% and a decrease in omission rate from 32.0% to 5.0%.Furthermore, the average assessment time was shortened by 6.0 minutes, markedly enhancing the efficiency of the evaluation process.Conclusions The optimized neurological function assessment system for spinal cord injury patients has proven effective in enhancing both the accuracy and efficiency of assessments, while significantly minimizing subjective errors.This system holds considerable potential for widespread clinical adoption and application.
论著

CXCL4、MMP-9、miR-24对急性脑梗死早期神经功能恶化的预测价值

Predictive value of CXCL4,MMP-9 and miR-24 on early neurological deterioration of acute cerebral infarction

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目的 研究CXC趋化因子配体4(CXCL4)、基质金属蛋白酶-9(MMP-9)、微小RNA-24(miR-24)对急性脑梗死(ACI)早期神经功能恶化(END)的预测价值。方法 分别选择2020年1月—2021年6月我院收治的30例ACI早期END患者(ACI+END组),30例单纯ACI患者(ACI组),同时期30例健康人群作为对照组,检测受试者CXCL4、MMP-9、miR-24表达情况及存在的相关性,分析血清CXCL4、MMP-9、miR-24表达情况与ACI早期发生END的关系。结果 CXCL4、MMP-9水平在对照组、ACI组、ACI+END组中依次升高,miR-24相对表达量依次降低(P<0.05)。血清CXCL4、MMP-9、miR-24水平在轻度、重度患者中呈升高趋势,miR-24相对表达呈降低趋势(P<0.05)。Logistic回归分析血清CXCL4、MMP-9、miR-24表达异常与ACI早期发生END独立相关(P<0.05)。经Pearson相关性分析发现,CXCL4与MMP-9之间呈正相关(r=0.584,P=0.001);CXCL4、miR-24之间呈负相关(r=-0.569,P=0.001),MMP-9、miR-24之间呈负相关(r=-0.567,P=0.001)。ROC曲线显示,与CXCL4、MMP-9、miR-24单项预测相比,三项联合对ACI的关系及对早期END的预测价值较高(P<0.05)。结论 CXCL4、MMP-9、miR-24在ACI发生END时出现异常表达,检测CXCL4、MMP-9、miR-24水平对ACI早期END具有一定预测价值,可尽早制定相关措施干预,提高治疗效率。
Objective To study the predictive value of CXC chemokine ligand 4(CXCL4),matrix metalloproteinase-9(MMP-9),microRNA-24(miR-24)in early neurological deterioration(END)of acute cerebral infarction(ACI).Methods A total of 30 patients with ACI early END(ACI+END group)and 30 patients with ACI only(ACI group)who were admitted to our hospital from January 2020 to June 2021 were selected,and 30 healthy people(control group)who underwent physical examination in our hospital during the same period were selected.Expressions of CXCL4,MMP-9,and miR-24 were detected and their correlations were analyzed,and the relationship between the expressions of serum CXCL4,MMP-9,miR-24 and the early occurrence of END in ACI were analyzed.Results The levels of CXCL4 and MMP-9 were increased in the control group,ACI group and ACI+END group in turn,and the relative expression of miR-24 was decreased in turn,and the differences among the groups were statistically significant(P<0.05).The levels of serum CXCL4,MMP-9,and miR-24 increased in mild and severe patients,while the relative expression of miR-24 decreased,and the differences between groups were statistically significant(P<0.05).Logistic regression analysis showed that abnormal expressions of serum CXCL4,MMP-9 and miR-24 were independently correlated with the early occurrence of END in ACI(P<0.05).After Pearson correlation analysis,it was found that there was a positive correlation between CXCL4 and MMP-9(r=0.584,P=0.001),a negative correlation between CXCL4 and miR-24(r=-0.569,P=0.001);a negative correlation between MMP-9 and miR-24(r=-0.567,P=0.001).The ROC curve showed that compared with the single prediction of CXCL4,MMP-9 and miR-24,the predictive value of the combined prediction on ACI and early END were higher(P<0.05).Conclusions CXCL4,MMP-9,and miR-24 are abnormally expressed in ACI when END occurs.Detection of CXCL4,MMP-9,and miR-24 levels has certain predictive value for early END of ACI,and relevant measures can be formulated as soon as possible to improve treatment efficiency.
论著

颈动脉内膜剥脱术不同时间预处理对患者术后应激反应及神经功能的影响

Effects of different time preconditioning on postoperative stress response and neurological function of patients undergoing carotid endarterectomy

:55-59
 
目的 对比颈动脉内膜剥脱术(CEA)不同时间预处理对患者术后应激反应及神经功能的影响。方法 回顾性收集2019年12月—2022年12月在我院择期行CEA术治疗的74例颈动脉狭窄(CS)患者临床资料,按远隔缺血预处理(RIPC)时间不同分成2组,其中A组37例(术前1 h进行预处理)、B组37例(术前24 h进行预处理)。对比2组术前1 d、麻醉诱导后、切皮时交感神经反应指标[收缩压(SBP)、心率(HR)、舒张压(DBP)]变化及手术前后简易精神状态评价量表(MMSE)评分、应激指标[去甲肾上腺素(NE)、白细胞介素-6(IL-6)、皮质醇(Cor)]、神经功能指标[脑源性神经营养因子(BDNF)、神经元特异性烯醇化酶(NSE)、中枢神经特异蛋白(S-100β)]水平。结果 与A组相比,麻醉诱导后B组SBP、HR、DBP水平更高,切皮时SBP、HR、DBP水平更低(P<0.05);与A组相比,B组术后7 d、30 d MMSE评分更高(P<0.05);术后12 h、24 h 2组血清NE、Cor、IL-6水平均较术前1 d升高(P<0.05),但2组比较差异无统计学意义(P>0.05);与A组相比,B组术后12 h、24 h血清S-100β、NSE水平更低,血清BDNF水平更高(P<0.05)。结论 CEA术前实施RIPC可减轻脑损伤,发挥脑保护作用,但与术前1 h实施RIPC相比,于术前24 h实施RIPC更有助于维持机体血流动力学稳定,促进认知功能及预后恢复。
Objective To compare the effects of different time preconditioning of carotid endarterectomy(CEA)on postoperative stress response and neurological function.Methods From December 2019 to December 2022,74 patients with carotid stenosis(CS)who were selected for CEA treatment in our hospital were retrospectively collected and divided into two groups according to the time of remote ischemic preconditioning(RIPC),including 37 cases in group A(preconditioning at 1 hour before surgery)and 37 cases in group B(preconditioning at 24 hours before surgery).The changes of sympathetic response indexes [systolic blood pressure(SBP),heart rate(HR),diastolic blood pressure(DBP)] in the 2 groups at 1 d before surgery,after the anesthesia induction,and at the time of skin incision before and after surgery,and the scores of the Mini-Mental State Examination(MMSE),stress indexes [norepinephrine(NE),interleukin-6(IL-6),cortisol(Cor)],and neurological function indexes [brain-derived neurotrophic factor(BDNF),neuron specific enolase(NSE),central nervous specific protein(S-100β)].Results Compared with group A,the levels of SBP,HR and DBP in group B after anesthesia induction were higher,and the levels of SBP,HR and DBP were lower during skin resection(P<0.05).Compared with group A,group B had higher MMSE scores at 7 and 30 days after surgery(P<0.05).The serum levels of NE,Cor and IL-6 in the 2 groups were increased 12 h and 24 h after surgery compared with 1 day before surgery(P<0.05),but there was no significant difference between the 2 groups(P>0.05).Compared with group A,serum S-100β and NSE levels in group B were lower at 12 h and 24 h after surgery,and serum BDNF level was higher in group B(P<0.05).Conclusions The administration of RIPC before CEA can reduce brain injury and play a protective role in brain.However,compared with the administration of RIPC 1 h before surgery,the administration of RIPC 24 h before surgery is more conducive to maintaining hemodynamic stability,promoting cognitive function and prognostic recovery.
论著

阿托伐他汀对卒中后轻度认知功能障碍、神经功能恢复及脑血管储备能力的影响

Effects of atorvastatin on mild cognitive impairment, neurological recovery and cerebrovascular reserve capacity after stroke

:18-21
 
目的 探讨不同剂量阿托伐他汀治疗能否作用于脑血管储备能力机制,进而影响卒中后轻度认知功能障碍患者的认知功能水平及神经功能。方法 纳入2018年5月—2020年5月期间,在本院神经内科住院的100例卒中后轻度认知障碍患者。随机分为大剂量(阿托伐他汀40 mg/d)组和小剂量(阿托伐他汀10 mg/d)组。记录半年后的简易精神状态量表(MMSE)评分、神经功能评分(NIHSS)和脑血管储备能力。结果 大剂量组的MMSE评分、NIHSS评分优于小剂量组,大剂量组的脑血管储备能力改善明显,2组之间有统计学差异。脑血管储备能力提高与认知功能改善有相关性。结论 大剂量阿托伐他汀治疗可明显改善卒中后轻度认知功能障碍患者的脑血管储备能力,并促进患者认知功能及神经功能恢复。
Objective To investigate whether different doses of atorvastatin can contribute to the mechanism of cerebrovascular reserve capacity, and then affect the level of cognitive function and neurological function in patients with mild cognitive impairment after stroke. Methods A total of 100 patients with mild cognitive impairment after stroke hospitalized in the department of neurology from May 2018 to May 2020 were recorded. They were randomly divided into high-dose (atorvastatin 40 mg/d) group and low-dose (atorvastatin 10 mg/d) group. The Mini-Mental State Examination (MMSE), National Institute of Health Stroke Scale (NIHSS) and cerebrovascular reserve capacity were recorded half a year later. Results The scores of MMSE and NIHSS in the high-dose group were higher than those in the low-dose group. The cerebrovascular reserve capacity of the high-dose group was significantly improved, and there was significant difference between the two groups. There was a correlation between the improvement of cerebrovascular reserve capacity and cognitive function. Conclusions High dose of atorvastatin could significantly improve the cerebrovascular reserve capacity of patients with mild cognitive impairment after stroke, and promote the recovery of cognitive function and neurological function.
临床诊疗

控制性减压术对重型颅脑损伤患者神经功能、颅内压及预后的影响

The influence of controllability decompression on neurological function, intracranial pressure and prognosis of severe craniocerebral injury

:114-116
 
目的 观察控制性减压术对重型颅脑损伤患者神经功能、颅内压及预后的影响。方法 将我院2016年3月—2017年2月治疗的94例重型颅脑损伤患者作为研究对象,入选者均依据随机数表法分为两组,各47例。对照组实施大骨瓣减压术,观察组实施控制性减压术。观察手术前后两组神经功能、颅内压及预后等。结果 术前2组神经行为认知状态检查表(NCSE)评分、颅内压对比,差异无统计学意义(P>0.05);术后观察组NCSE评分高于对照组,颅内压低于对照组,差异有统计学意义(P<0.05);2组预后等级相比,观察组优于对照组,差异有统计学意义(P<0.05)。结论 将控制性减压术应用于重型颅脑损伤患者中降颅内压效果良好,可恢复受损神经功能,提升患者康复效果,改善预后。
论著

小骨窗显微手术不同手术时机对高血压脑出血患者疗效及神经功能的影响

Curative effects of microsurgical treatment with small bone flap craniotomy on patients with hypertensive cerebral hemorrhage and on their nerve function in different timing of surgery

:46-48
 
目的 探讨小骨窗显微手术不同手术时机对高血压脑出血患者疗效及神经功能的影响。方法 选取我院2014年5月—2016年5月收治的80例高血压脑出血患者作为研究对象,脑出血量约30~40 mL,根据出血到手术时间不同分为两组,每组40例。从出血到手术时间<6 h者为超早期作为观察组,出血到手术时间处于6~24 h间者为早期作为对照组,比较两组患者治疗后1个月GOS(格拉斯哥预后)优良率,治疗后3周、6周的斯堪的纳维亚(SSS)评分,治疗后3个月、6个月的生存质量评分及治疗后的生存情况、再出血情况。结果 观察组治疗后1个月GOS优良率为77.50%,相对于对照组明显上升(P<0.05);观察组治疗后3周、6周的SSS评分较对照组明显降低(P<0.01);观察组治疗后3个月、6个月的生存质量评分较对照组明显升高(P<0.01);两组治疗后的生存率差异有统计学意义(P<0.05),再出血率差异无统计学意义(P>0.05)。结论 对高血压脑出血患者在超早期行小骨窗显微手术可提高疗效,明显改善患者神经功能,提高生活质量及生存率,值得临床推广。
Objective To investigate the curative effects of microsurgical treatment with small bone flap craniotomy in patients with hypertensive cerebral hemorrhage and on their nerve function in different timing of surgery. Methods To select 80 cases of hypertensive cerebral hemorrhage in our hospital from May 2014 to May 2016 as the research object. The amount of cerebral hemorrhage of the patients was about 30-40 mL. According to the different time of bleeding, they were divided into two groups, 40 cases in each group. The super early period that the time from bleeding to operation was less than 6 h was regarded as the observation group, and the early period that the time from bleeding to operation is during 6~24 h was regarded as the control group. To compare the GOS (Glasgow outcome) excellent rate of patients in two groups in 1 month after treatment, the Scandinavia (SSS) score in 3 weeks and 6 weeks after treatment, and the quality of life score and survival and re-bleeding condition after treatment in 3 months and 6 months. Results Compared with the control group, the GOS excellent rate in the observation group in 1 month after treatment was 77.50% which increased significantly (P<0.05); the SSS score in the observation group in 3 weeks and 6 weeks after treatment was significantly lower than that in the control group (P<0.01); The quality of life score in the observation group in 3 months and 6 months after treatment was significantly higher than that in the control group (P<0.01); There was statistically significant difference in survival rate between the two groups after treatment (P<0.05), and the re-bleeding rate showed no significant difference (P>0.05). Conclusion The curative effects of microsurgical treatment with small bone flap craniotomy on patients with hypertensive cerebral hemorrhage is significant, which can improve the patients' neurological function, the life quality and survival rate, thus it is worthy of clinical promotion.
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