神经内镜微创与开颅血肿清除术治疗高血压脑出血的效果比较  

Comparison on effects of minimally invasive neuroendoscopic surgery versus craniotomy hematoma removal on hypertensive intracerebral hemorrhage

作　　者：周贤文[1] 张志远[2] 周世聪[1] 王莹[1] 王永胜[1] Zhou Xianwen;Zhang Zhiyuan;Zhou Shicong;Wang Ying;Wang Yongsheng(Department of Neurosurgery,Binzhou Central Hospital,Binzhou 251700,China;Department of Neurosurgery,Liaocheng People’s Hospital,Liaocheng 252000,China)

机构地区：[1]山东省滨州市中心医院神经外科,251700 [2]山东省聊城市人民医院神经外科,252000

出　　处：《中国实用医刊》2020年第13期53-56,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较神经内镜微创与开颅血肿清除术治疗高血压脑出血的临床疗效。方法抽取2018年4月至2019年2月滨州市中心医院收治的高血压脑出血患者80例,根据手术方式分为对照组(n=38)与观察组(n=42)。对照组行开颅血肿清除术治疗,观察组行神经内镜微创手术治疗,比较两组手术指标、格拉斯哥昏迷评分法(GCS)评分、并发症发生率及预后效果。结果观察组手术用时、术中出血量、重症监护病房(ICU)住院时间均少于对照组,血肿清除率高于对照组,差异有统计学意义(P<0.05)。两组术后7 d GCS评分均较术前升高,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率(2.38%,1/42)低于对照组(18.42%,7/38),差异有统计学意义(P<0.05)。观察组预后效果优于对照组,差异有统计学意义(P<0.05)。结论高血压脑出血患者采用神经内镜微创手术治疗可提高血肿清除率,提高GCS评分,减轻手术创伤,减少术后并发症,改善预后。Objective To compare the effects of craniotomy hematoma removal and minimally invasive neuroendoscopic surgery on patients with hypertensive intracerebral hemorrhage.Methods A total of 80 patients with hypertensive intracerebral hemorrhage admitted to Binzhou Central Hospital from April 2018 to February 2019 were selected and divided into control group (n=38) and observation group (n=42) according to surgical methods. The control group received craniotomy hematoma removal, and the observation group received minimally invasive neuroendoscopic surgery. The surgical indicators, Glasgow Coma Scale (GCS) score, complication rate and prognosis were compared between the two groups.Results The operation time, intraoperative blood loss and Intensive Care Unit (ICU) hospitalization time of the observation group were less than those of the control group, and the hematoma clearance rate of the observation group was higher than that of the control group, with statistically significant differences (P<0.05). The GCS score of the two groups on the 7th day after surgery was higher than those before surgery, and the GCS score of observation group was higher than that of control group (P<0.05). The overall incidence of complications in the observation group (2.38%, 1/42) was lower than that in the control group (18.42%, 7/38), and the difference was statistically significant (P<0.05). The prognosis of the observation group was better than that of the control group (P<0.05).Conclusions Minimally invasive neuroendoscopic surgery for hypertensive intracerebral hemorrhage can improve hematoma clearance rate and GCS score, reduce surgical trauma and incidence of postoperative complications, promote prognosis.

关 键 词：高血压脑出血 神经内镜微创手术 开颅血肿清除术 血肿清除率 格拉斯哥昏迷指数 

分 类 号：R651.12[医药卫生—外科学]