神经内镜联合颅骨钻孔软管负压引流术治疗混合型硬膜下血肿的效果  

Effect of neuroendoscopy combined with skull drilling and negative pressure drainage on mixed subdural hematoma

作　　者：游涛[1] 叶世阳 YOU Tao;YE Shiyang(Department of Neurosurgery,Pingxiang People's Hospital,Jiangxi Province,Pingxiang337000,China)

机构地区：[1]江西省萍乡市人民医院神经外科,江西萍乡337000

出　　处：《中国当代医药》2022年第34期15-18,共4页China Modern Medicine

基　　金：江西省萍乡市科技计划项目(2019PX008)。

摘　　要：目的观察经内镜联合颅骨钻孔软管负压引流术治疗混合型硬膜下血肿的效果。方法选取2020年7月至2021年9月江西省萍乡市人民医院收治的112例混合型硬膜下血肿患者作为研究对象,按照随机数字表法分为对照组和观察组,每组56例。对照组采用常规钻孔冲洗引流术治疗,观察组采用神经内镜联合颅骨钻孔软管负压引流术治疗,术后两组患者均接受阿托伐他汀治疗,比较两组患者疗效、住院时间、复发率、术后2个月颅内积气量及术前、术后2个月颅内血肿量、血清神经元特异性烯醇化酶(NSE)水平,并比较两组患者术前,术后1、3个月Barthel指数评定量表(BI)评分。结果观察组总有效率高于对照组,差异有统计学意义(P<0.05)。观察组术后2个月颅内血肿量、积气量少于对照组,血清NSE水平低于对照组,差异有统计学意义(P<0.05)。观察组术后1、3个月BI评分高于对照组,差异有统计学意义(P<0.05)。观察组住院时间短于对照组,而复发率低于对照组,差异有统计学意义(P<0.05)。结论对混合型硬膜下血肿行神经内镜联合颅骨钻孔软管负压引流术治疗可显著清除颅内血肿,减少颅内积气,疗效确切,有助于患者预后康复。Objective To observe the effect of neuroendoscopy combined with skull drilling and negative pressure drainage on mixed subdural hematoma.Methods A total of 112 patients with mixed subdural hematoma diagnosed and treated in Pingxiang People's Hospital of Jiangxi Province from July 2020 to September 2021 were selected as the research subjects.They were divided into control group and observation group according to the random number table method,with 56 cases in each group.The control group was treated with conventional drilling and irrigation drainage,and the observation group was treated with neuroendoscopy combined with skull drilling and hose negative pressure drainage.After operation,both groups were treated with Atorvastatin.The curative effect,hospital stay,recurrence rate,intracranial volume 2 months after operation,intracranial hematoma volume before operation and 2 months after operation,and serum neuron-specific enolase(NSE)level,Barthel index(BI)score before operation and 1,3 months after operation were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).The intracranial pneumatosis volume and intracranial hematoma volume in the observation group were less than those in the control group 2 months after operation,while the serum NSE level was lower than that in the control group,the differences were statistically significant(P<0.05).The BI score of the observation group was higher than that of the control group at 1 and 3 months after operation,the difference was statistically significant(P<0.05).The hospital stay of the observation group was shorter than that of the control group,and the recurrence rate was lower than that of the control group,the differences were statistically significant(P<0.05).Conclusion The treatment of mixed subdural hematoma by neuroendoscopy combined with skull drilling and hose negative pressure drainage can significantly clear the intracranial hema

关 键 词：混合型硬膜下血肿 神经内镜 颅骨钻孔软管负压引流术 阿托伐他汀 

分 类 号：R651[医药卫生—外科学]