神经内镜手术及外侧裂入路开颅术治疗基底节高血压脑出血的疗效  

Curative effect of neuroendoscopy and craniotomy through lateral fissure approach on hypertensive intracerebral hemorrhage in basal ganglia

作　　者：金二亮 潘万喜 周健[1] 夏开来[1] 郑刚[1] JIN Er-liang;PAN Wan-xi;ZHOU Jian;XIA Kai-lai;ZHENG Gang(Department of Neurosurgery,People s Hospital of Three Gorges University,Yichang First People s Hospital,Yichang 443000,Hubei,China)

机构地区：[1]三峡大学人民医院·宜昌市第一人民医院神经外科,湖北宜昌443000

出　　处：《川北医学院学报》2022年第9期1127-1130,共4页Journal of North Sichuan Medical College

基　　金：湖北省卫生健康委员会科研课题(WJ2019H385)。

摘　　要：目的:探讨神经内镜手术及外侧裂入路开颅术治疗基底节高血压脑出血(HICH)的疗效。方法:根据手术方式不同将92例基底节区HICH患者分为内镜组(n=36)和开颅组(n=56);内镜组行神经内镜手术治疗,开颅组行外侧裂入路开颅术治疗。比较两组患者血肿清除率、手术时间、术中出血量、手术前后神经功能缺损评分(NDS)、日常生活能力量表(ADL)、炎症因子水平、术后并发症发生率及预后情况。结果:与开颅组相比,内镜组血肿清除率更高,手术时间更短,术中出血量更少(P<0.05);术后1 d,内镜组CRP、PCT和IL-6水平低于开颅组(P<0.05);术后3个月,内镜组NDS评分低于开颅组,且ADL评分高于开颅组(P<0.05);术后,两组并发症总发生率比较,差异无统计学意义(P>0.05),内镜组预后良好率高于开颅组(P<0.05)。结论:相比外侧裂入路开颅术,神经内镜手术治疗基底节区HICH效果更好,预后更佳。Objective:To explore the curative effect of neuroendoscopy and craniotomy through lateral fissure approach on hypertensive intracerebral hemorrhage(HICH)in basal ganglia.Methods:A total of 92 patients with HICH in basal ganglia were enrolled as the research objects.According to different surgical methods,they were divided into endoscopy group(36 cases,neuroendoscopy)and craniotomy group(56 cases,craniotomy through lateral fissure approach).The hematoma clearance rate,operation time,intraoperative blood loss,scores of neurological deficit scale(NDS)and activity of daily life scale(ADL),levels of inflammatory factors before and after surgery,incidence of postoperative complications and prognosis were compared between the two groups.Results:Compared with craniotomy group,hematoma clearance rate was higher,operation time was shorter and intraoperative blood loss was less in endoscopy group(P<0.05).At 1 d after surgery,levels of CRP,PCT and IL-6 in endoscopy group were lower than those in craniotomy group(P<0.05).At 3 months after surgery,NDS score in endoscopy group was lower than that in craniotomy group,and ADL score was higher than that in craniotomy group(P<0.05).There was no significant difference in incidence of postoperative complications between the two groups(P>0.05).The good prognosis rate in endoscopy group was higher than that in craniotomy group(P<0.05).Conclusion:Compared with craniotomy through lateral fissure approach,neuroendoscopy has better effect and prognosis in the treatment of basal ganglia HICH.

关 键 词：高血压脑出血 神经内镜手术 外侧裂入路开颅术 基底节 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R651.1[医药卫生—临床医学]