神经内镜和小骨窗血肿清除术对基底节出血患者肢体活动和认知功能治疗效果的比较研究  

Comparison of neuroendoscopy and small bone window on removal of hematoma in the treatment of limb activity and cognitive function of basal ganglia hemorrhage patients

作　　者：胡世颉[1] 李兵[1] 闫志强[1] 胡学安[1] 李亮[1] 罗鹏[1] 贺亚龙[1] 孙季冬[1] 费舟[1] 

机构地区：[1]第四军医大学西京医院神经外科,西安710032

出　　处：《中国医学前沿杂志（电子版）》2017年第5期46-50,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：陕西省社会发展科技攻关项目(2015SF030)

摘　　要：目的对比研究神经内镜和小骨窗血肿清除术对基底节出血患者肢体活动和认知功能的治疗效果。方法选取2014年11月至2016年11月于本院就诊的100例基底节出血患者为研究对象,采用随机数字生成器将其分为A组和B组,每组各50例,A组患者接受神经内镜治疗,B组患者接受小骨窗血肿清除术治疗。对比两组患者并发症发生情况、Fugl-Meyer运动功能量表评分、简明精神状态检查量表评分及格拉斯哥预后评分,评价神经内镜和小骨窗血肿清除术对基底节出血患者的疗效。结果术后,A组轻型基底节出血患者肺部感染、再出血及颅内感染的发生率均显著低于B组轻型患者(P<0.05)。A组轻型基底节出血患者术后30天和60天的Fugl-Meyer运动功能量表评分和简明精神状态检查量表评分均显著高于同期B组轻型患者(P<0.05)。术后两组患者死亡和植物生存的发生率均较低,A组轻型基底节出血患者轻度和重度残疾的发生率显著低于B组轻型患者(P<0.05),恢复良好率显著高于B组轻型患者(P<0.05)。结论两种手术方法对不同程度血肿患者的疗效具有明显差异。神经内镜对轻度血肿患者的清除效果更佳,小骨窗血肿清除术更适合于中、重度血肿患者的治疗。Objective To analyze and compare the effect of the neuroendoscopy and small window removal of hematoma on limb activity and cognitive function in patients with basal ganglia hemorrhage. Method 100 patients with basal ganglia hemorrhage in our hospital were selected from November 2014 to November 2016, they were divided into group A （n = 50） and group B （n = 50） by using random number generator. Patients in group A were treated with neuroendoscopy, while patients in group B were given small window removal of hematoma. The incidence of postoperative complications, Fugl-Meyer assessment score, mini-mental state examination score and Glasgow prognosis score were compared between the two groups. Result For mild patients, the incidence rate of pulmonary infection, rehaemorrhagia and intracranial infection in group A were significantly lower than those in group B （P 〈 0.05）. Besides, 30 days and 60 days after surgery, the Fugl-Meyer assessment scores and mini-mental state examination scores of mild patients in group A were significantly higher than mild patients in group B （P 〈 0.05）. There were few death and plant survival cases in both groups. However, the incidence rate of moderate and severe disability of mild patients in group A were lower than mild patients in group B （P 〈 0.05）, and recovery rate of mild patients in group A was higher than mild patients in group B （P 〈 0.05）. Conclusion There is obvious difference in the efficacy on different degrees of hematoma patients using different surgical methods. Neuroendoscopy therapy has a better therapeutical effect for mild hematoma patients, while small window removal of hematoma is more suitable for moderate and severe hematoma patients.

关 键 词：神经内镜 小骨窗血肿清除术 基底节出血 肢体活动 认知功能 

分 类 号：R651.1[医药卫生—外科学]