神经内镜微创手术与小骨窗开颅显微手术治疗幕上高血压脑出血的临床价值体会  

Clinical value experience of minimally invasive neuroendoscopic surgery and small bone window craniotomy microsurgery in the treatment of supratentorial hypertensive intracerebral hemorrhage

作　　者：马学雷 MA Xue-lei(Second Department of Surgery,The Third People＇s Hospital of Pingdu City,Pingdu 266753,China)

机构地区：[1]平度市第三人民医院外二科,266753

出　　处：《中国实用医药》2018年第26期7-9,共3页China Practical Medicine

摘　　要：目的探究神经内镜微创手术与小骨窗开颅显微手术治疗幕上高血压脑出血的临床价值。方法 86例幕上高血压脑出血患者,随机分为对照组和观察组,各43例。对照组采用小骨窗开颅显微手术治疗,观察组采用神经内镜微创手术治疗。比较两组患者的手术指标、并发症发生情况、血肿清除情况,治疗前后中国脑卒中临床神经功能缺损程度评分量表(CSS)评分及日常生活能力量表(ADL)评分。结果观察组术中出血量少于对照组,手术时间、重症加强护理病房(ICU)入住时间短于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率2.33%低于对照组的16.28%,血肿清除率97.67%高于对照组的74.42%,差异有统计学意义(P<0.05)。治疗前两组CSS评分及ADL评分比较差异无统计学意义(P>0.05);治疗后观察组CSS评分低于对照组,ADL评分高于对照组,差异有统计学意义(P<0.05)。结论神经内镜微创手术治疗幕上高血压脑出血的临床效果优于小骨窗开颅显微手术,能够在缩短治疗时间的基础上促进神经功能,且进一步改善预后,值得应用及推广。Objective To investigate the clinical value experience of minimally invasive neuroendoscopic surgery and small bone window craniotomy microsurgery in the treatment of supratentorial hypertensive intracerebral hemorrhage. Methods A total of 86 patients with supratentorial hypertensive intracerebral hemorrhage were randomly divided into control group and observation group, 43 cases in each group. The control group was treated with small bone window craniotomy microsurgery, the observation group was treated with minimally invasive neuroendoscopic surgery. The operative indexes, occurrence of complications, hematoma clearance, Chinese stroke scale （CSS） score and activity of daily living scale （ADL） score before and after treatment between the two groups were compared. Results The intraoperative blood loss of the observation group was significantly less than that of the control group, the operative time and intensive care unit （ICU） length instay of the observation group were significantly shorter than those in the control group, the differences were statistically significant （P〈0.05）. The incidence of complications in the observation group was 2.33%, which was significantly lower than 16.28% in the control group, the clearance rate of hematoma in the observation group was 97.67%, which was significantly higher than 74.42% in the control group, the differences were statistically significant （P〈0.05）. There were no significant differences in the CSS score and ADL score between the two groups before treatment （P〉O.05）. The CSS score of the observation group after treatment was significantly lower than that of the control group, and the ADL score was significantly higher than that of the control group, the differences were statistically significant （P〈0.05）. Conclusion The clinical effect of minimally invasive neuroendoscopic surgery for supratentorial hypertensive intracerebral hemorrhage is superior to small bone window craniotomy microsurgery. It can promote the recovery of nerve f

关 键 词：神经内镜微创手术 小骨窗开颅显微手术 幕上高血压脑出血 

分 类 号：R651.12[医药卫生—外科学]