手术和保守治疗对高血压脑出血破入脑室患者神经元特异性烯醇酶的影响

目的观察手术和保守治疗对高血压脑出血破入脑室患者的疗效,及其对神经元特异性烯醇酶(NSE)的影响。方法选择脑出血破入脑室患者82例,按照家属的意愿将其分为手术组64例和保守组18例并给予相应治疗。观察2组疗效,记录2组治疗前后的Barthel指数、NIHSS评分和NSE水平的变化。结果手术组的总有效率为56%,保守组为33%,2组比较有显著性差异(P0.05)。手术组的电解质紊乱,心律失常、消化道出血和病死率均明显低于保守组(P均0.05),而2组感染和肝肾功能不全的发生率比较无显著性差异(P均0.05)。2组治疗后NIHSS评分和NSE水平均较治疗前明显降低(P均0.01),Barthel指数较治疗前明显升高(P0.01),手术组改善水平较对照组更为明显(P0.01)。结论手术治疗高血压脑出血破入脑室的疗效显著优于保守组,可能与降低颅内压力、缓解颅内神经组织的损伤及机体的NSE水平降低有关。

Effect of surgical and conservative treatment on neuron-specific enolase in patients with hypertensive intracerebral hemorrhage broken into ventricles of brain

Objective It is to observe the clinical efficacy of surgical and conservative treatment in patients with the hypertensive cerebral hemorrhage broken into ventricles of brain,and its impact on neuron-specific enolase （NSE）.Methods 82 patients with cerebral hemorrhage broken into ventricles in accordance with the wishes of families,were divided into surgery group （64 cases） and conservative group （18 cases） and given respective therapy.The clinical efficacy were observed after treatment,the changes of Barthel index,NIHSS score and NSE levels were observed before and after treatment.Results The total effective rate was 56％ in surgical group,while 33％ in conservative group,the clinical efficacy of surgical treatment was superior to the conservative treatment （P ＜ 0.05）.The electrolyte imbalance,cardiac arrhythmias,gastrointestinal bleeding,and mortality in surgical group was significantly lower compared with the conservative group （P ＜ 0.05）,while the difference in incidence of infection and kidney dysfunction was not statistically significant.After treatment,the NIHSS score and NSE levels in both groups were significantly lower than those before treatment （P ＜ 0.01）,however,the Barthel index was significantly higher compared with the pre-treatment （P ＜ 0.01）,the reducing or increasing levels in surgical treatment were more obvious compared with conservative treatment （P ＜ 0.01）.Conclusion The efficacy of surgical therapy on hypertensive intracerebral hemorrhage broken into ventricles of brain is significantly better than that of conservative therapy,which may be associated with decreasing intracranial pressure,relieving intracranial nerve damage,and reducing the body＇s levels of NSE.