Monitoring of intracranial pressure in patients with hypertensive intracerebral hemorrhage after minimally invasive surgery and its correlation with nerve injury,inflammatory stress response / 中国基层医药

ABSTRACT

Objective To monitor the itrracranial pressure in patients with hypertensive intracerebral hemorrhage after minimally invasive surgery and to explore its correlation with nerve injury,inflammatory stress response.Methods From December 2014 to October 2017,60 patients of hypertensive intracerebral hemorrhage underwent minimally invasive surgery in Taizhou Municipal Hospital were chosen in the research.According to the prognosis,the patients were divided into hematoma clearance group (n =45) and rebleeding group(n =15).The levels of intracranial pressure 24h after surgery,serum contents of nerve injury related indicators,inflammatory mediators and oxidative stress indicators were compared between the two groups.Pearson test was used to evaluate the correlation between intracranial pressure 24h after surgery and nerve injury,inflammatory stress response.Results 24 h after surgery,the intracranial pressure in the hematoma clearance group was (349.27 ± 45.81)mmH2O,which was lower than (511.09 ± 57.64) mmH2O in the rebleeding group (t =-11.093,P ＜ 0.05).The serum contents of nerve injury markers such as NSE,h-FABP,GFAP,S 100B in the hematoma clearance group were (9.37 ± 1.05)ng/L,(7.04 ±0.85) μg/L,(7.19 ± 0.85) μg/L,(20.47 ± 3.19) ng/L,respectively,which were significantly lower than those in the rebleeding group [(14.58 ± 1.62) ng/L,(11.36 ± 1.62) μg/L,(16.23 ± 1.72) μg/L,(45.87 ± 5.62) ng/L](t =-14.414,-13.330,-26.989,-21.749,all P ＜ 0.05),the BNP level of the hematoma clearance group [(22.61 ± 2.85) μg/L] was significantly higher than (15.28 ± 1.79) μg/L ih the rebleeding group (t =11.732,P ＜ 0.05).The levels of inflammatory mediators such as IL-6,IL-1β,TNF-α in the hematoma clearance group were (5.28 ± 0.59) ng/L,(9.73 ± 1.54) ng/L,(15.28 ± i.76) ng/L,respectively,which were lower than those in the rebleeding group [(11.07 ± 1.63) ng/L,(20.46 ± 2.95) ng/L,(23.51 ± 3.79) ng/L] (t =-20.410,-18.225,-11.445,all P ＜ 0.05).The levels of antioxidant factors such as SOD,CAT in the hematoma clearance group were (49.58 ± 6.21) U/L,(68.11 ± 7.59) U/L,repectively,which were significantly higher than those in the rebleeding group [(32.16 ±4.05) U/L,(45.23 ±5.61)U/L] (t=10.138,10.715,all P ＜0.05).The contents of ROS,AOPP in the hematoma clearance group were (15.28 ± 1.73) μg/L,(10.94 ± 1.62) μg/L,respectively,which were lower than those in the rebleeding group [(34.19 ± 4.25) μg/L,(22.53 ± 2.18) μg/L] (t =-24.632,-21.945,all P ＜0.05).Pearson test showed that the level in 24h intracranial pressure in patients with hypertensive intracerebral hemorrhage was positively correlated with the degree of nerve injury,inflammation stress(r =0.371,0.483,0.427,0.519,0.537,all P ＜ 0.05).Conclusion Monitoring of intracranial pressure after minimally invasive surgery for hypertensive intracerebral hemorrhage,can effectively judge the severity of nerve injury and inflammatory stress reaction,and can predict the risk of recurrent intracerebral hemorrhage.