前额锁孔入路神经内镜血肿清除术治疗中等量高血压基底核区脑出血的效果分析  

Analysis of the Effect of Neuroendoscopic Hematoma Removal by Forehead Keyhole Approach in the Treatment of Cerebral Hemorrhage in the Basal Nucleus Region of Moderate Hypertension

作　　者：王余军 WANG Yujun(Department of Neurosurgery,Xinyi people's Hospital,Xinyi,Jiangsu Province,221400 China)

机构地区：[1]新沂市人民医院神经外科,江苏新沂221400

出　　处：《中外医疗》2022年第2期83-86,共4页China & Foreign Medical Treatment

摘　　要：目的探究前额锁孔入路神经内镜血肿清除术治疗中等量高血压基底核区脑出血的效果。方法方便选取2018年5月—2021年5月该院收治的中等量高血压基底核区脑出血患者50例为研究对象,依据随机数表法分为对照组(25例)与观察组(25例),对照组行翼点经侧裂显微镜下血肿清除术治疗,观察组行前额锁孔入路神经内镜血肿清除术治疗,对比两组患者手术时间、血肿清除率、死亡、再出血情况及术后NIHSS与BI评分、GOS预后指标情况、并发症发生率情况。结果观察组患者平均手术时间为(90.25±3.13)min,低于对照组患者(147.46±4.28)min,差异有统计学意义(t=53.947,P<0.05);两组患者术后24 h血肿清除率(100.00%vs 92.00%)差异无统计学意义(χ^(2)=0.521,P>0.05);两组患者病死率对比差异无统计学意义(P>0.05);观察组患者无再出血情况,对照组再出血率为4.00%,差异无统计学意义(P>0.05);观察组患者术后NIHSS评分小于对照组,BI评分大于对照组患者,差异有统计学意义(t=7.267、13.552,P<0.05);术后观察组患者并发症发生率(4.00%)低于对照组(33.33%),差异有统计学意义(χ^(2)=5.207,P<0.05);通过GOS指标评估,观察组患者预后优于对照组患者,差异有统计学意义(Z=-2.810,P<0.05)。结论前额锁孔入路行神经内镜血肿清除术治疗中等量高血压基底核区脑出血疗效显著,手术时间短,血肿清除率较高,止血更为彻底,对功能区损伤更少,术后神经缺损及生活功能改善效果理想。Objective To explore the effect of neuroendoscopic hematoma removal through the forehead keyhole approach in the treatment of cerebral hemorrhage in the basal nucleus region of moderate hypertension.Methods Fifty patients with moderately hypertensive intracerebral hemorrhage in the basal nucleus region admitted to the hospital from May 2018 to May 2021 were conveniently selected as the research objects.According to the random number table method,they were divided into control group(25 cases)and observation group(25 cases).The control group was treated with pterional hematoma removal under a lateral fissure microscope,and the observation group was treated with neuroendoscopic hematoma removal through the forehead keyhole approach.The operation time,hematoma clearance rate,death,rebleeding,postoperative NIHSS and BI scores,GOS prognostic indicators,and complication rates were compared between the two groups.Results The average operation time of the observation group was(90.25±3.13)min,which was shorter than that of the control group(147.46±4.28)min,the difference was statistically significant(t=53.947,P<0.05);the clearance rate of hematoma at 24 hours postoperatively was similar between the two groups(100.00%vs 92.00%),and there was no statistically significant difference(χ^(2)=0.521,P>0.05);there was no significant difference in mortality between the two groups(P>0.05);there was no rebleeding in the observation group,and the rebleeding rate in the control group was 4.00%,the difference was not statistically significant(P>0.05);the postoperative NIHSS score of the observation group was lower than that of the control group,and the BI score was higher than that of the control group,the difference was statistically significant(t=7.267,13.552,P<0.05);the incidence of complications in the observation group(4.00%)was lower than that in the control group(33.33%),the difference was statistically significant(χ^(2)=5.207,P<0.05);through the evaluation of GOS indicators,the prognosis of patients in the observation group w

关 键 词：前额锁孔入路 神经内镜血肿清除术 高血压脑出血 

分 类 号：R743[医药卫生—神经病学与精神病学]