神经内镜血肿清除术治疗分隔型慢性硬膜下血肿的临床效果  

Analysis on clinical effects of neuroendoscopic hematoma removal for septate CSDH

作　　者：邓光策[1] 关北漩 曾敏敏[1] 王岳华[1] 李国峰[1] DENG Guangce;GUAN Beixuan;ZENG Minmin;WANG Yuehua;LI Guofeng(Department of Neurosurgery,the Sixth Affiliated Hospital of Guangzhou Medical University,Qingyuan People's Hospital,Guangdong,Qingyuan 511500,China)

机构地区：[1]广州医科大学附属第六医院广东省清远市人民医院神经外科,广东清远511500

出　　处：《中国医药科学》2021年第14期181-184,共4页China Medicine And Pharmacy

摘　　要：目的探讨神经内镜辅助血肿清除术治疗分隔型慢性硬膜下血肿(CSDH)的效果及其对术后并发症的影响。方法回顾性分析2015年1月至2020年1月广州医科大学附属第六医院收治的分隔型CSDH患者87例,根据手术选择方式分为对照组(常规血肿钻孔引流术,45例)与观察组(神经内镜血肿清除术,42例)。比较两组患者术后30 d血肿清除率、手术时间、术后引流时间、住院时间,术后30 d神经功能缺损评分(CSS)、日常生活能力评分(ADL),术后6个月并发症发生率。结果观察组患者术后30 d血肿清除率高于对照组,手术时间长于对照组,术后引流时间、住院时间短于对照组,差异均有统计学意义(P<0.05);观察组患者术后30 d CSS评分低于对照组,ADL评分高于对照组,差异均有统计学意义(P<0.05);观察组患者术后6个月并发症总发生率低于对照组(P<0.05)。结论神经内镜血肿清除术治疗CSDH效果比常规血肿钻孔引流术好,可提高术后30 d血肿清除率,缩短术后引流时间及住院时间,改善神经功能及日常生活能力,降低术后并发症的发生,值得临床推广应用。Objective To investigate the effects of neuroendoscopy-assisted hematoma removal for the treatment of septate chronic subdural hematoma(CSDH)and the impacts on postoperative complications.Methods A total of 87 patients with septate CSDH admitted to the Sixth Affiliated Hospital of Guangzhou Medical University from January 2015 to J anuary 2020 were retrospectively analyzed.T hese patients were divided into the control group(with conventional hematoma drilling and drainage,n=45)and the observation group(with neuroendoscopic hematoma removal,n=42)according to the operativemode.The hematoma clearance rateat 30 d after operation,operation duration,postoperative drainage duration,hospital stay,score of Chinese stroke scale(CSS)and score of Activity of Daily Living(ADL)at 30 d after operation,and complication rate at 6 months after operation were compared between the two groups of patients.Results At 30 d after operation,the hematoma clearance rate of patients in the observation group was higher than that of the control group,the operation duration was longer than that of the control group,and the postoperative drainage duration and hospital stay were shorter than those of the control group,all with statistically significant differences(P<0.05).At 30 d after operation,the CSS score of patients in the observation group was lower than that of the control group,while the ADL score was higher than that of the control group,with statistically significant differences(P<0.05).The total complication rate of patients in the observation group was lower than that of the control group in 6 months after operation(P<0.05).Conclusion Neuroendoscopic hematoma removal for CSDH is more effective than conventional hematoma drilling and drainage,which can improve the hematoma clearance rate at 30 d after operation,shorten the postoperative drainage duration and hospital stay,improve neurological function and ADL of patients,and reduce the occurrence of postoperative complications.Therefore,it is worthy of clinica l promotion and applicati

关 键 词：神经内镜 分隔 慢性硬膜下血肿 并发症 

分 类 号：R651.1[医药卫生—外科学]