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探讨  

Clinical Value of Neuroendoscopic Minimally Invasive Surgery and Small Bone Window Craniotomy in the Treatment of Supratentorial Hypertensive Intracerebral Hemorrhage

作　　者：周贤文[1] Zhou Xianwen(Binzhou Central Hospital, Binzhou Shandong 251700, China)

机构地区：[1]滨州市中心医院神经外科

出　　处：《临床研究》2019年第8期16-18,共3页Clinical Research

基　　金：山东省医药卫生科技发展计划项目(2016WS0199)

摘　　要：目的探讨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。方法选取2016年03月-2018年09月在滨州市中心医院接受治疗的幕上高血压脑出血患者94例作为研究对象,随机分为两组,即常规组47例(小骨窗开颅显微手术)、研究组47例(神经内镜微创手术)。结果研究组手术耗时、ICU治疗时间均短于常规组,且手术失血量低于常规组(t=17.642/19.013/10.176,P<0.05);研究组颅脑感染、肺部感染发生率明显低于常规组,且预后优良率、血肿清除率均高于常规组(χ^2=6.618/5.041/10.616/8.706,P<0.05);研究组ADL(日常生活活动能力)评分高于常规组、CSS(神经功能缺损)评分低于常规组(t=11.935/10.792,P<0.05)。结论相较于小骨窗开颅显微手术,神经内镜微创手术在治疗幕上高血压脑出血患者,不仅操作简单、术后并发症少,而且预后优良,有利于患者早日康复。Objective To investigate the clinical value of neuroendoscopic minimally invasive surgery and small bone window craniotomy in the treatment of supratentorial hypertensive intracerebral hemorrhage. Methods 94 patients with supratentorial hypertensive intracerebral hemorrhage were randomLy divided into two groups, namely 47 patients in the conventional group (microsurgery with small bone window craniotomy) and 47 patients in the research group (minimally invasive neuroendoscopic surgery). Results: the operation time and ICU treatment time in the study group were shorter than those in the conventional group and the blood loss was lower than that in the conventional group(t=17.642/19.013/10.176, P < 0.05). Team cerebral infection, pulmonary infection, and less than normal group and the prognosis was the hematoma clearance rate were higher than in normal group (χ^2= 6.618/5.041/10.616/8.706, P < 0.05);ADL(daily living activity) score of the study group was higher than that of the conventional group , and CSS(neural function defect) score was lower than that of the conventional group(t =11.935/10.792, P < 0.05).Conclusion: compared with microcraniotomy with small bone window, minimally invasive neuroendoscopic surgery for patients with supratentorial hypertensive cerebral hemorrhage is not only simple to operate, but also has a good prognosis, which is conducive to early recovery.

关 键 词：神经内镜微创手术 小骨窗开颅显微手术 高血压 脑出血 临床价值 

分 类 号：R651.12[医药卫生—外科学]