分析术中超声引导神经内镜手术与脑室外引流术治疗脑室内血肿伴铸型的临床效果  

Analysis on the Clinical Effect of Intraoperative Ultrasound-Guided Neuroendoscopy and External Ventricular Drainage in the Treatment of Intraventricular Hematoma with Casts

作　　者：刘广飞[1] 蓝鹏[1] LIU Guangfei;LAN Peng(Neurosurgery,Pizhou Hospital of Traditional Chinese Medicine,Pizhou,Jiangsu Province,221300 China)

机构地区：[1]邳州市中医院神经外科,江苏邳州221300

出　　处：《系统医学》2022年第4期132-135,共4页Systems Medicine

摘　　要：目的分析在脑室内血肿伴铸型治疗中,采取术中超声引导神经内镜手术与脑室外引流术治疗干预的临床价值。方法选择2018年1月—2020年12月该院收治的66例脑室内血肿伴铸型患者为研究对象,采取随机数表法,将其均分为两组,观察组(33例)接受术中超声引导神经内镜手术治疗,对照组(33例)接受传统脑室外引流术治疗;对比两组患者的预后效果、格拉斯哥昏迷指数(GCS)评分、并发症发生率、日常生活能力(Barthel指数)评分、生活质量(SF-36)评分。结果观察组术后24 h血肿清除率为(66.19±9.55)%,高于对照组的(19.76±5.41)%,差异有统计学意义(t=24.300,P<0.05),且其留置引流管时间、NICU住院时间及总体住院时间比对照组均有明显缩短,差异有统计学意义(t=15.327、3.531、2.380,P<0.05)。术后24 h,观察组GCS评分为(12.73±2.94)分,高于对照组的(9.85±2.67)分,差异有统计学意义(t=4.166,P<0.05)。两组术后并发症发生率分别为15.15%、27.27%,差异无统计学意义(χ^(2)=1.451,P>0.05)。术后6个月,观察组Barthel指数评分高于对照组,差异有统计学意义(t=3.668,P<0.05),同时,观察组各方面SF-36评分高于对照组,差异有统计学意义(t=2.975、2.067、3.720、2.473、2.054,P<0.05)。结论在脑室内血肿伴铸型治疗中,采取术中超声引导神经内镜手术对比传统脑室外引流术干预效果显著,可有助于促进患者术后恢复,并提升其生活自理能力及生活质量。Objective To analyze the clinical value of intraoperative ultrasound-guided neuroendoscopy and extraventricular drainage in the treatment of intraventricular hematoma with casting.Methods A total of 66 patients with intraventricular hematoma with casts who were treated in the hospital from January 2018 to December 2020 were selected as the research objects,and they were divided into two groups by random number table method.The observation group(33 cases)received intraoperative ultrasound-guided neuroendoscopic surgery,and the control group(33 cases)received traditional extraventricular drainage.The two groups of patients under different treatment regimens were compared and observed:prognosis,glasgow coma scale(GCS)score,complication rate,ability of daily living(Barthel index)score,and quality of life(SF-36)score.Results The 24 h hematoma clearance rate in the observation group was(66.19±9.55)%,which was higher than that in the control group(19.76±5.41)%,and the difference was statistically significant(t=24.300,P<0.05).And its indwelling drainage tube time,NICU length of stay and overall hospital stay were significantly shortened compared with the control group,and the difference was statistically significant(t=15.327,3.531,2.380,P<0.05).At 24 h after operation,the GCS score of the observation group was(12.73±2.94)points,which was higher than that of the control group(9.85±2.67)points,with a statistically significant difference(t=4.166,P<0.05).The postoperative complication rates of the two groups were 15.15%and 27.27%,respectively,the difference was not statistically significant(χ^(2)=1.451,P>0.05).6 months after operation,the Barthel index score of the observation group was higher than that of the control group,the difference was statistically significant(t=3.668,P<0.05).At the same time,the SF-36 scores of the observation group were higher than those of the control group in all aspects,the difference was statistically significant(t=2.975,2.067,3.720,2.473,2.054,P<0.05).Conclusion In the treatment of intrav

关 键 词：脑室内血肿伴铸型 超声引导神经内镜手术 脑室外引流术 

分 类 号：R743[医药卫生—神经病学与精神病学]