CT定位辅助神经内镜手术对脑包虫病的疗效分析  

Effect analysis of CT-assisted neuro endoscopic surgery on cerebral hydatid disease

作　　者：沈良伟[1] 李涛 金祝华 黄刚 SHEN Liang-wei;LI Tao;JIN Zhu-hua(Department of Neurosurgery,People's Hospital of Ganzi Tibetan Autonomous Prefecture,Kangding 626000,China)

机构地区：[1]甘孜藏族自治州人民医院神经外科,康定626000

出　　处：《临床神经病学杂志》2023年第1期39-43,共5页Journal of Clinical Neurology

摘　　要：目的探讨CT定位辅助神经内镜手术对脑包虫病的疗效。方法将62例脑包虫病患者按照随机数字表法分为CT辅助定位组(31例)及对照组(31例)。CT辅助定位组采用CT定位辅助神经内镜手术治疗,对照组采用常规开颅手术治疗。比较两组围术期指标、创伤相关指标[纤维蛋白原(FBG)、凝血酶原时间(TT)、凝血酶原时间(PT)、去甲肾上腺素(NE)、皮质醇(Cor)、醛固酮(ALD)]、神经功能评分、CSF神经肽指标[精氨酸升压素(AVP)、催产素(OT)、β-内啡肽(β-EP)]及并发症发生率、治疗费用。结果与对照组比较,CT辅助定位组手术时间、切口长度、术后下床时间、住院时间显著缩短,术中出血量显著减少(均P<0.05)。与对照组比较,CT辅助定位组术前血清NE、Cor、ALD水平差异无统计学意义(均P>0.05),术后1 d、3 d血清NE、Cor、ALD水平显著降低(均P<0.05)。与对照组比较,CT辅助定位组术前FBG、TT、PT水平差异无统计学意义(均P>0.05),术后1 d、3 d FBG、TT、PT水平显著降低(均P<0.05)。与对照组比较,CT辅助定位组术后1个月mRS评分显著降低(P<0.05)。与对照组比较,CT辅助定位组术前AVP、OT、β-EP水平差异无统计学意义(均P>0.05),术后1个月、6个月AVP、OT、β-EP水平显著升高(均P<0.05)。CT辅助定位组并发症发生率显著低于对照组(χ2=4.679,P=0.031)。CT辅助定位组治疗费用较对照组显著升高(t=7.871,P<0.001)。结论CT定位辅助神经内镜手术治疗脑包虫病具有手术时间短、创伤小、术后康复快等特点,对创伤反应及凝血功能影响较小,可有效促使CSF神经肽水平及神经功能恢复,安全性高。Objective To investigate the effect of CT localization-assisted neuro endoscopy on cerebral hydatid disease.Methods Sixty-two patients with cerebral hydatid disease were divided into CT-assisted localization group(31 cases)and control group(31 cases)according to the random number table method.The CT-assisted positioning group was treated with CT positioning-assisted neuro endoscopic surgery,and the control group was treated with conventional craniotomy.Comparison of perioperative indicators and trauma-related indicators[fibrinogen(FBG),prothrombin time(TT),prothrombin time(PT),norepinephrine(NE),cortisol(Cor),aldosterone(ALD)],neurological function score,CSF neuropeptide indexes[arginine vasopressin(AVP),oxytocin(OT),β-endorphin(β-EP)],incidence of complications and treatment costs.Results Compared with those in the control group,the operation time,incision length,postoperative ambulation time and hospital stay in the CT-assisted positioning group were significantly shortened,and the intraoperative blood loss was significantly reduced(all P<0.05).Compared with those in the control group,there was no significant difference in serum NE,Cor and ALD levels before surgery in the CT-assisted localization group(all P>0.05),and serum NE,Cor and ALD levels were significantly decreased at 1 d and 3 d after surgery(all P<0.05).Compared with those in the control group,there was no significant difference in the levels of FBG,TT and PT before surgery in the CT-assisted positioning group(all P>0.05),and the levels of FBG,TT and PT at 1 d and 3 d after surgery were significantly decreased(all P<0.05).Compared with that in the control group,the mRS score of the CT-assisted positioning group was significantly lower at 1 month after surgery(P<0.05).Compared with those in the control group,there was no significant difference in the levels of AVP,OT andβ-EP before surgery in the CT-assisted positioning group(all P>0.05),and the levels of AVP,OT andβ-EP were significantly increased at 1 month and 6 months after surgery(all P<0.05)

关 键 词：脑包虫病 CT定位 神经内镜 神经肽 神经功能 

分 类 号：R53[医药卫生—内科学]