经额内镜与经侧裂显微镜手术治疗基底节区脑出血的疗效对比  

Efficacy of transfrontal endoscopic versus transsylvian microscopic surgery for treatment of cerebral basal ganglia hemorrhage: a comparative study

作　　者：黄朝觉[1] 黄玮[1] 周全[1] 杨雷霆[1] 余永佳[1] 李唐[1] 王春喜 HUANG Chao-jue;HUANG Wei;ZHOU Quan;YANG Lei-ting;YU Yong-jia;LI Tang;WANG Chun-xi(Department of Neurosurgery,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院神经外科

出　　处：《广西医学》2020年第2期121-124,共4页Guangxi Medical Journal

基　　金：国家自然科学基金(81601023)

摘　　要：目的比较经额内镜与经侧裂显微镜手术治疗基底节区脑出血的疗效。方法回顾性分析85例手术治疗的基底节区脑出血患者的临床资料,其中采用经额内镜手术治疗41例(经额内镜组),经侧裂显微镜手术治疗44例(经侧裂显微组)。比较两组患者手术时间、术中出血量、术后血肿清除率、术后再出血率、术后颅内感染率、术后脑梗发生率、术后7 d格拉斯哥昏迷量表(GCS)评分及术后6个月格拉斯哥预后量表(GOS)评分。结果经额内镜组手术时间短于经侧裂显微组,术后脑梗发生率低于经侧裂显微组(均P<0.05),而两组患者术中出血量、术后血肿清除率、术后再出血率、术后颅内感染率、术后7 d GCS评分、术后GOS评分比较,差异均无统计学意义(均P>0.05)。结论经额内镜技术治疗基底节区脑出血患者疗效与经侧裂显微镜手术相当,手术时间更短,术后脑梗死发生率更低。Objective To compare the efficacy between transfrontal endoscopic versus transsylvian microscopic surgery for treating cerebral basal ganglia hemorrhage.Methods The clinical data of 85 patients with cerebral basal ganglia hemorrhage treated by surgery were analyzed retrospectively,among which 41 patients(transfrontal endoscopic group)underwent transfrontal endoscopic surgery and 44 patients(transsylvian microscopic group)underwent transsylvian microscopic surgery.Operation duration,intraoperative blood loss,postoperative hematoma clearance rate,postoperative rebleeding rate,postoperative intracranial infection rate,incidence rate of postoperative cerebral infarction,7-day postoperative Glasgow Coma Scale(GCS)score,and 6-month postoperative Glasgow Outcome Scale(GOS)score were compared between the two groups.Results The transfrontal endoscopic group exhibited shorter operation duration,and lower incidence rate of postoperative cerebral infarction in comparison with the transsylvian microscopic group(all P<0.05).Moreover,there was no statistically significant difference between the two groups in intraoperative blood loss,postoperative hematoma clearance rate,postoperative intracranial infection rate,postoperative rebleeding rate,7-day postoperative GCS score,or postoperative GOS score(all P>0.05).Conclusion Transfrontal endoscopy is similar to transsylvian microscopic surgery in efficacy for treating patients with cerebral basal ganglia hemorrhage,achieving shorter operation duration,lower incidence rates of cerebral infarction.

关 键 词：基底节区脑出血 经额内镜下血肿清除术 经侧裂显微镜下清除术 格拉斯哥昏迷量表 格拉斯哥预后量表 并发症 疗效 

分 类 号：R743.34[医药卫生—神经病学与精神病学]