神经内镜治疗高血压脑出血疗效观察  

Neuroendoscopy in the Treatment of Hypertensive Intracerebral Hemorrhage and Their Influence on Postoperative Rebleeding

作　　者：许国栋[1] 武莉娜[1] 邢俊领[1] 王玉峰[1] Xu Guodong;Wu Lina;Xing Junling(Department of Neurosurgery,the Third Affiliated Hospital of Xinxiang Medical College)

机构地区：[1]新乡医学院第三附属医院神经外科

出　　处：《长治医学院学报》2019年第4期295-298,共4页Journal of Changzhi Medical College

摘　　要：目的:探讨神经内镜用于临床治疗高血压脑出血的效果。方法:回顾性分析90例高血压脑出血行神经内镜和显微镜手术治疗的患者病例资料,采用神经内镜手术方式治疗的为内镜组,采用显微镜手术方式治疗的为显微镜组,每组45例患者。比较2组患者手术相关指标(血肿清除面积、手术耗时和术中出血量)、术后再出血发生率、平均住院时间及出院后1个月格拉斯哥预后(GOS)评分。结果:2组手术指标比较,内镜组血肿清除面积[(7.56±1.92)cm 2]显著高于显微镜组[(6.21±1.18)cm^2](P<0.05),内镜组手术耗时和术中出血量分别为(0.98±0.06)h、(40.71±3.55)mL,显著少于显微镜组的(1.26±0.11)h、(42.96±3.62)mL(P<0.05);术后再出血发生率比较,内镜组(4.44%)显著低于显微镜组(17.78%)(P<0.05);住院时间比较,内镜组[(9.26±1.59)d]显著短于显微镜组[(10.38±2.16)d](P<0.05);GOS评分比较,内镜组[(8.31±1.16)分]显著高于显微镜组[(7.04±1.03)分](P<0.05)。结论:神经内镜治疗高血压脑出血的效果优于显微镜,能有效降低术后再出血发生率,缩短住院时间,有利于改善患者预后情况。Objective:To study the effects of neuroendoscopy and microscopy in the treatment of hypertensive intracerebral hemorrhage,and to explore the influence of two different treatment methods on postoperative rebleeding.Methods:90 patients with hypertensive intracerebral hemorrhage admitted to the hospital were divided into two groups according to the random number table method,with 45 patients in each group.Neuroendoscopic group was treated with neuroendoscopic surgery and microsurgery group was treated with microsurgery.The surgery conditions were recorded during surgery,including hematoma clearance area,operative time and intraoperative blood loss.The postoperative rebleeding during hospitalization was timely monitored,and the incidence rate of postoperative rebleeding was calculated.The average hospital stay was counted in the two groups at discharge,and the Glasgow Outcome Scale(GOS)score was calculated and compared between the two groups at 1 month after discharge.The treatment effects of the two different surgical methods and the influence on postoperative rebleeding were analyzed comprehensively.Results:In terms of surgical efficiency,the hematoma clearance area in neuroendoscopic group was significantly higher than that in microsurgery group[(7.56±1.92)cm 2 vs(6.21±1.18)cm^2](P<0.05),and the operative time and intraoperative blood loss were significantly lower than those in microsurgery group[(0.98±0.06)h vs(1.26±0.11)h,(40.71±3.55)mL vs(42.96±3.62)mL](P<0.05).The incidence rate of postoperative rebleeding in neuroendoscopic group was significantly lower than that in microsurgery group(4.44%vs 17.78%)(P<0.05).The average hospital stay in neuroendoscopic group was significantly shorter than that in microsurgery group[(9.26±1.59)d vs(10.38±2.16)d](P<0.05).The GOS score in neuroendoscopic group was significantly higher than that in microsurgery group[(8.31±1.16)points vs(7.04±1.03)points](P<0.05).Conclusion:Neuroendoscopy for hypertensive intracerebral hemorrhage has better effects than microscopy,and i

关 键 词：神经内镜 显微镜 高血压脑出血 术后再出血 

分 类 号：R651.1[医药卫生—外科学]