B超引导神经内镜微创手术治疗高血压脑出血的效果  

Effect of neuroendoscopic minimally invasive surgery guided by B-ultrasound on hypertensive intracerebral hemorrhage

作　　者：刘琦[1] 马肃[1] 杨建龙[1] 宋彦彬[1] 车震[1] 李涵[1] 郝东宁[1] 吴浩[1] LIU Qi;MA Su;YANG Jian-long;SONG Yan-bin;CHE Zhen;LI Han;HAO Dong-ning;WU Hao(the First Hospital of Yulin,Yulin 718000,China)

机构地区：[1]榆林市第一医院

出　　处：《临床医学研究与实践》2020年第2期38-40,共3页Clinical Research and Practice

摘　　要：目的观察B超引导神经内镜微创手术治疗高血压脑出血的效果。方法将我院2016年8月至2018年8月收治的60例高血压脑出血患者随机分为开颅组和微创组,各30例。开颅组给予开颅血肿清除术,微创组给予B超引导神经内镜微创手术。对比两组患者的手术相关指标、手术前、后NIHSS及GCS评分、临床疗效及术后并发症发生情况。结果微创组的手术时间显著短于开颅组,术中失血量显著少于开颅组,血肿清除率显著高于开颅组,差异具有统计学意义(P<0.05)。手术后,两组的颅内压、脑水肿体积、NIHSS评分均显著降低,GCS评分均显著升高,且微创组均优于开颅组(P<0.05)。微创组的治疗总有效率为93.3%,显著高于开颅组的73.3%(P<0.05)。微创组术后并发症总发生率显著低于开颅组,差异具有统计学意义(P<0.05)。结论与开颅血肿清除术相比,给予高血压脑出血患者B超引导神经内镜微创手术治疗的效果更好,可提高血肿清除率,减轻脑组织损伤,降低术后并发症发生率。Objective To observe the effect of neuroendoscopic minimally invasive surgery guided by B-ultrasound on hypertensive intracerebral hemorrhage. Methods From August 2016 to August 2018, 60 patients with hypertensive intracerebral hemorrhage treated in our hospital were randomly divided into craniotomy group and minimally invasive group,with 30 cases in each group. The craniotomy group was given craniotomy evacuation of hematoma, while the minimally invasive group was treated with neuroendoscopic minimally invasive surgery guided by B-ultrasound. The operation related indexes, NIHSS and GCS scores before and after operation, clinical efficacy and postoperative complications were compared between the two groups. Results The operation time of the minimally invasive group was significantly shorter than that of the craniotomy group, the intraoperative blood loss was significantly less than that of the craniotomy group, and the clearance rate of hematoma was significantly higher than that of the craniotomy group, the differences were statistically significant(P <0.05). After operation, the intracranial pressure, brain edema volume, NIHSS scores of the two groups reduced significantly, GCS scores increased significantly, and those of the minimally invasive group were better than the craniotomy group(P<0.05). The total effective rate of treatment in the minimally invasive group was 93.3%, which was significantly higher than 73.3% in the craniotomy group(P<0.05). The total incidence of postoperative complications in the minimally invasive group was significantly lower than that in the craniotomy group, the difference was statistically significant(P<0.05).Conclusion Compared with craniotomy evacuation of hematoma, neuroendoscopic minimally invasive surgery guided by Bultrasound for hypertensive intracerebral hemorrhage is more effective, which can improve the clearance rate of hematoma,reduce brain tissue damage and the incidence of postoperative complications.

关 键 词：神经内镜 B超 高血压脑出血 微创手术 

分 类 号：R651.1[医药卫生—外科学]