高压氧辅助神经内镜经侧裂入路治疗高血压脑出血的临床疗效  

Clinical efficacy analysis of hyperbaric oxygen-assisted neuroendoscopic transsylvian approach in the treatment of hypertensive intracerebral hemorrhage

作　　者：徐汝飞 XU Rufei(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院,河南洛阳471000

出　　处：《山东第一医科大学（山东省医学科学院）学报》2022年第7期525-528,共4页Journal of Shandong First Medical University ＆ Shandong Academy of Medical Sciences

摘　　要：目的探讨高压氧辅助神经内镜经侧裂入路治疗高血压脑出血的临床疗效及对脑血管动力学、神经功能恢复的影响。方法选取2018年10月至2020年5月河南科技大学第一附属医院收治的高血压脑出血患者120例,根据术后是否进行高压氧治疗分为单纯手术组与高压氧组,各60例。单纯手术组患者行神经内镜经侧裂入路手术治疗,高压氧组患者在单纯手术组的基础上联合使用高压氧治疗,比较两组患者治疗前后脑血管动力学指标,治疗1个月后评估预后、神经功能、生活质量、并发症情况。结果治疗后,两组患者脑血管平均流速(Vmean)、平均血流量(Qmean)均升高,外周阻力(R)、临界压(critical pressure,CP)降低,且高压氧组改善效果优于单纯手术组,差异有统计学意义(P<0.05)。术后1个月经过评估,高压氧组患者哥斯拉哥昏迷评分(Glasgow coma scale,GCS)优于单纯手术组患者,同时肌力恢复效果优于单纯手术组,差异有统计学意义(P<0.05)。治疗后,两组患者的美国国立卫生院卒中量表(National Institutes of Health stroke scale,NIHSS)评分低于治疗前,且高压氧组低于单纯手术组;日常生活活动能力评定量表(activity of daily living,ADL)评分均高于治疗前,且高压氧组高于单纯手术组,差异均有统计学意义(P<0.05);术后1个月两组均有患者出现肺部感染和癫痫,单纯手术组患者出现2例颅内感染和5例术后再出血,高压氧组患者并发症总发生率低于单纯手术组患者,差异有统计学意义(P<0.05)。结论高压氧辅助神经内镜经侧裂入路治疗高血压脑出血的临床疗效突出,可改善患者脑血管动力学指标,提升预后,进而提高患者术后生活质量。Objective:To investigate the clinical efficacy of hyperbaric oxygen-assisted neuroendoscopy through sylvian approach in the treatment of hypertensive intracerebral hemorrhage and its effect on cerebral vascular dynamics and neurological recovery.Methods:A total of 120 patients with hypertensive intracerebral hemorrhage who were treated from October 2018 to May 2020 were selected and divided into a simple operation group and a hyperbaric oxygen group according to whether hyperbaric oxygen therapy was performed postoperatively,with 60 cases in each group.The patients in the simple operation group were treated with neuroendoscopic transsylvian approach,and the patients in the hyperbaric oxygen group were treated with hyperbaric oxygen on the basis of the simple operation group.Prognosis,neurological function,quality of life,and complications were assessed.Results:After treatment,Vmean and Qmean increased,R and CP decreased in both groups,and the improvement effect of hyperbaric oxygen group was better than that of simple operation group(P<0.05).One month after the operation,the GCS score of the hyperbaric oxygen group was better than that of the simple operation group,and the muscle strength recovery effect was better than that of the simple operation group(P<0.05).After treatment,the NIHSS scores of the two groups were lower than those before treatment,and the hyperbaric oxygen group was lower than the simple operation group;the ADL scores were higher than those before treatment,and the hyperbaric oxygen group was higher than the simple surgery group(all P<0.05);One month after the operation,pulmonary infection and epilepsy occurred in both groups.At the same time,there were 2 cases of intracranial infection and 5 cases of postoperative rebleeding in the simple operation group.After evaluation,the total incidence of complications in the hyperbaric oxygen group was lower than that in the simple operation group.(P<0.05).Conclusion:Hyperbaric oxygenassisted neuroendoscopic transsylvian approach in the treatment of hyp

关 键 词：高血压脑出血 高压氧 神经内镜经侧裂入路手术 脑血管动力学 预后 

分 类 号：R651.1[医药卫生—外科学]