显微镜下锁孔手术治疗高血压基底节出血的临床疗效  

The clinical effect of keyhole surgery under microscope in the treatment of hypertensive basal ganglia hemorrhage

作　　者：李刚 Li Gang(Department of Neurosurgery,Guihang Guiyang Hospital,Guiyang 550006,China)

机构地区：[1]贵航贵阳医院神经外科,550006

出　　处：《国际医药卫生导报》2021年第10期1516-1519,共4页International Medicine and Health Guidance News

摘　　要：目的探析高血压基底节出血用显微镜下锁孔手术治疗的效果。方法选取2018年10月至2020年7月于本院接受治疗的高血压基底节出血患者80例为观察对象,以治疗形式的不同之处分为两组,各40例。对照组男26例,女14例,年龄(58.58±3.58)岁;研究组男24例,女16例,年龄(59.05±3.66)岁。对照组应用骨瓣开颅手术治疗,研究组应用显微镜下锁孔手术治疗。对比两组血肿清除率、意识障碍恢复效果、格拉斯哥昏迷评分(Glasgow Coma Scale,GCS)、神经功能缺损评分、并发症发生率、复发率。结果两组高血压基底节出血患者血肿清除率比较,差异无统计学意义(P>0.05)。术后2周,研究组意识障碍恢复有效率为85.0%(34/40),高于对照组42.5%(17/40),差异有统计学意义(P<0.05)。治疗前,两组高血压基底节出血患者GCS、神经功能缺损评分比较,差异均无统计学意义(均P>0.05);治疗后,研究组GCS评分为(13.57±1.05)分,高于对照组(8.95±1.66)分,神经功能缺损评分为(6.18±1.37)分,低于对照组(14.57±2.96)分,差异均有统计学意义(均P<0.05)。研究组并发症发生率、复发率分别为5.0%(2/40)、2.5%(1/40),均低于对照组25.0%(10/40)、17.5%(7/40),差异均有统计学意义(均P<0.05)。结论在高血压基底节出血治疗中,采用显微镜下锁孔手术治疗,既能提升意识障碍恢复效果与GCS评分,又能减轻神经功能缺损程度、减少并发症与复发率,且此手术的血肿清除率与开颅手术相近,可将其作为高血压基底节出血的主要治疗方案。Objective To explore the clinical effect of keyhole surgery under microscope in the treatment of hypertensive basal ganglia hemorrhage.Methods From October 2018 to July 2020,80 cases of patients with hypertensive basal ganglia hemorrhage who were treated in our hospital were selected as observation objects,and they were divided into a control group and a study group according to the different treatment methods,40 cases in each group.There were 26 males and 14 females in the control group,with the age of(58.58±3.58)years old;there were 24 males and 16 females in the study group,with the age of(59.05±3.66)years old.The control group was treated with bone flap craniotomy,and the study group was treated with keyhole surgery under the microscope.The hematoma clearance rate,the recovery effect of consciousness disturbance,Glasgow Coma Scale(GCS)score,neurological impairment score,complication rate,and recurrence rate were compared between the two groups.Results There was no statistically significant difference in the hematoma clearance rate between the two groups(P>0.05).Two weeks after the operation,the recovery effective rate of consciousness disturbance in the study group was higher than that in the control group[85.0%(34/40)vs.42.5%(17/40)](P<0.05).Before the treatment,there were no statistically significant differences in the GCS score and neurological impairment score between the two groups;after the treatment,the GCS score in the study group was higher than that in the control group[(13.57±1.05)points vs.(8.95±1.66)points],the neurological impairment score was lower than that in the control group[(6.18±1.37)points vs.(14.57±2.96)points](both P<0.05).The complication rate and recurrence rate in the study group were 5.0%(2/40)and 2.5%(1/40),which were lower than those in the control group[25.0%(10/40)and 17.5%(7/40)](both P<0.05).Conclusions In the treatment of hypertensive basal ganglia hemorrhage,the application of keyhole surgery under the microscope can improve the recovery effect of consciousness distur

关 键 词：高血压基底节出血 显微镜下锁孔手术 血肿清除率 意识障碍恢复效果 

分 类 号：R651.1[医药卫生—外科学]