神经内镜经额入路治疗基底节区脑出血的疗效分析  

Analysis of the therapeutic effect of neuroendoscopyin the treatment of basal ganglia cerebral hemorrhage through transfrontal approach

作　　者：羊飞龙[1] 许伍环 唐协林[1] 黎乾科[1] 刘胜华[1] 何绍勇 侯小林[3] Yang Feilong;Xu Wuhuan;Tang Xielin;Li Qianke;Liu Shenghua;He Shaoyong;Hou Xiaolin(Department of neurosurgery,Santai hospital affiliated to North Sichuan Medical College,Mianyang,Sichuan,621100,China;Department of neurology,Santai hospital affiliated to North Sichuan Medical College,Mianyang,Sichuan,621100,China;Department of neurosurgery,affiliated hospital of Chengdu University of traditional Chinese medicine,Chengdu,Sichuan,610000,China)

机构地区：[1]川北医学院附属三台医院神经外科,四川绵阳621100 [2]川北医学院附属三台医院神经内科,四川绵阳621100 [3]成都中医药大学附属医院神经外科,四川成都610000

出　　处：《齐齐哈尔医学院学报》2023年第3期227-231,共5页Journal of Qiqihar Medical University

基　　金：四川省医学会静脉血栓栓塞症防治(恒瑞)专项科研课题(2019HR69)。

摘　　要：目的探讨神经内镜经额入路治疗基底节区脑出血的临床疗效。方法选择2018年4月—2020年9月本院神经外科收治的诊断为基底节区脑出血且需手术治疗的患者作为研究对象,随机数表法分为神经内镜组和显微镜开颅组两组,每组各58例。比较两组血肿清除率、手术时间、失血量、术后并发症、术后1周脑水肿及GCS评分、神经纤维束损毁程度、重症监护时间、30天内病死率、90天mRS评分等指标。结果神经内镜组血肿清除率、术后1周GCS评分高于显微镜组(P<0.05),神经内镜组手术时间、入住重症监护室时间短于显微镜组(P<0.05),神经内镜组失血量、神经纤维束破坏程度、神经内镜组肺部感染率低于显微镜组(P<0.05)。30天病死率比较两组无统计学差异(P>0.05)。神经内镜组90天mRS评分好于显微镜组(P<0.05)。结论神经内镜经额入路治疗基底节区脑出血可提高血肿清除率,减少神经纤维束的损伤,改善患者预后。Objective To investigate clinic effect of neuroendoscopy in the treatment of basal ganglia cerebral hemorrhage through transfrontal approach.Methods Patients diagnosed with cerebral hemorrhage in basal ganglia region and requiring surgical treatment admitted to neurosurgery department of our hospital from April 2018 to September 2020 were selected as research objects,and they were randomly divided into neuroendoscopy group and microscope craniotomy group,with 58 cases in each group.Hematoma evacuation rate,operation time,blood loss,postoperative complications,cerebral edema at 1 week after operation,GCS score,nerve fiber bundle damage degree,intensive care time,mortality within 30 days,mRS score at 90 days and other indicators were compared between the two groups.Results The evacuation rate of hematoma and the GCS score in the neuroendoscopy group were higher than those in the microscope group(P<0.05).The operation time and stay in the intensive care unit in the neuroendoscopy group were shorter than those in the microscope group(P<0.05).The blood loss,nerve fiber bundle destruction,and lung infection rate in the neuroendoscopy group were lower than those in the microscope group(P<0.05).There was no statistically different in 30-day mortality rate between the two groups(P>0.05).The 90-day mRS score of the neuroendoscopy group was better than that of the microscope group(P<0.05).Conclusions Neuroendoscopyapplied for the treatment of cerebral hemorrhage in the basal ganglia through transfrontal approachcan increase the evacuation rate of hematoma,reduce the damage of nerve fiber bundles,and improve the prognosis of patients.

关 键 词：神经内镜 经额入路 基底节 脑出血 

分 类 号：R741.05[医药卫生—神经病学与精神病学]