立体定向血肿穿刺抽吸术与立体定向神经内镜下血肿清除术治疗高血压基底节区脑出血的效果比较  

Comparison of the effects of stereotactic hematoma aspiration and stereotactic neuroendoscopic hematoma evacuation in the treatment of hypertensive basal ganglia hemorrhage

作　　者：邬慎新 周小峰 吴宗涛[1] WU Shenxin;ZHOU Xiaofeng;WU Zongtao(Ankang Hospital of Traditional Chinese Medicine,Ankang 725000,China)

机构地区：[1]安康市中医医院,陕西安康725000

出　　处：《临床医学研究与实践》2022年第25期32-35,共4页Clinical Research and Practice

基　　金：陕西省中医药管理局科研课题(No.2019-ZZ-LC020)。

摘　　要：目的 比较立体定向血肿穿刺抽吸术与立体定向神经内镜下血肿清除术治疗高血压基底节区脑出血的效果。方法选取2020年1月至12月我院收治的76例高血压基底节区脑出血患者为研究对象,根据手术方式不同将其分为参照组(n=38)和研究组(n=38)。参照组开展立体定向血肿穿刺抽吸术,研究组开展立体定向神经内镜下血肿清除术。比较两组的治疗效果。结果 研究组的手术时间长于参照组,术中出血量多于参照组,血肿清除率高于参照组,术后清醒时间早于参照组(P<0.05)。两组的术后并发症总发生率比较,差异无统计学意义(P>0.05)。研究组的日常生活能力优良率显著高于参照组,差异具有统计学意义(P<0.05)。术后1周,两组的白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)水平均降低,且研究组低于参照组,差异具有统计学意义(P<0.05)。术后1周,两组的运动、睁眼、语言评分均升高,美国国立卫生院卒中量表(NIHSS)评分均降低,且研究组优于参照组,差异具有统计学意义(P<0.05)。术后1周,两组的神经元特异性烯醇化酶(NSE)水平低于术前,神经营养因子-α(NTF-α)水平高于术前(P<0.05);但两组间比较,差异无统计学意义(P>0.05)。结论 相比于立体定向血肿穿刺抽吸术,立体定向神经内镜下血肿清除术治疗高血压基底节区脑出血的血肿清除率更高,且术后康复效果更佳。Objective To compare the effects of stereotactic hematoma aspiration and stereotactic neuroendoscopic hematoma evacuation in the treatment of hypertensive basal ganglia hemorrhage.Methods A total of 76 patients with hypertensive basal ganglia hemorrhage admitted in our hospital from January to December 2020 were selected as the research objects.According to different surgical methods,the patients were divided into reference group(n=38)and study group(n=38).The reference group carried out stereotactic hematoma aspiration,and the study group carried out stereotactic neuroendoscopic hematoma evacuation.The therapeutic effects of the two groups were compared.Results The operation time in the study group was longer than that in the reference group,the intraoperative blood loss was more than that in the reference group,the hematoma clearance rate was higher than that in the reference group,and the postoperative awake time was earlier than that in the reference group(P<0.05).There was no significant difference in the total incidence of postoperative complications between the two groups(P>0.05).The excellent and good rate of daily living ability in the study group was significantly higher than that in the reference group,and the difference was statistically significant(P<0.05).One week after operation,the levels of interleukin-4(IL-4),interleukin-6(IL-6)and high sensitive C-reactive protein(hs-CRP)in the two groups decreased,and those in the study group were lower than the reference group,the differences were statistically significant(P<0.05).One week after operation,the scores of exercise,eye opening,language in the two groups increased,the score of National Institutes of Health Strore Scale(NIHSS)decreased,and those in the study group were better than the reference group,the differences were statistically significant(P<0.05).One week after operation,the level of neuron specific enolase(NSE)in the two groups was lower than that before operation,and the level of neurotrophic factor-α(NTF-α)was higher than that before o

关 键 词：立体定向 血肿穿刺抽吸术 神经内镜 血肿清除术 高血压基底节区脑出血 血肿清除率 

分 类 号：R651.12[医药卫生—外科学]