神经内镜下血肿清除术与立体定向血肿清除术治疗丘脑出血的临床效果对比  

Comparison of clinical effects between endoscopic hematoma removal and stereotactic hematoma removal in the treatment of thalamic hemorrhage

作　　者：乐丙 张行泉[1] LE Bing;ZHANG Xingquan(Zhoushan Hospital,Zhejiang 316021,China)

机构地区：[1]浙江省舟山医院,舟山316021

出　　处：《浙江创伤外科》2023年第6期1035-1038,共4页Zhejiang Journal of Traumatic Surgery

摘　　要：目的比较神经内镜下血肿清除术与立体定向血肿清除术治疗丘脑出血的效果。方法选取2016年9月至2022年9月收治的71例丘脑出血患者,对其临床资料回顾性分析,根据手术方案分组,观察组36例行神经内镜下血肿清除术,对照组35例行立体定向血肿清除术,比较两组手术结果。结果观察组手术时间、住院时间较对照组短,术中出血量较对照组少,血肿清除率较对照组高(P<0.05);术前,两组GCS、NIHSS评分相比无显著差异(P>0.05),术后,观察组GCS评分更高、NIHSS评分更低(P<0.05);术前两组hs-CRP、TNF-α水平相比差异不显著(P>0.05),术后观察组各指标水平更低(P<0.05);观察组并发症发生率为5.56%,与对照组8.57%比较无显著差异(P>0.05)。结论与立体定向血肿清除术相比,神经内镜下血肿清除术治疗丘脑出血在减少出血量、提高血肿清除率、减轻炎性反应方面更有优势,利于减轻患者神经功能损伤,改善预后。Objective To compare the effects of neuroendoscopic hematoma removal and stereotactic hematoma removal in the treatment of thalamic hemorrhage.Methods The clinical data of 71 patients with thalamic hemorrhage admitted to our hospital from September 2016 to September 2022 were analyzed retrospectively.They were divided into two groups according to the operation plan.The observation group had 36 cases of neuroendoscopic hematoma removal,and the control group had 35 cases of stereotactic hematoma removal.The surgical results of the two groups were compared.Results The operation time and hospital stay in the observation group were shorter than those in the control group,the amount of intraoperative bleeding was less than that in the control group,and the hematoma clearance rate was higher than that in the control group(P<0.05).Before operation,there was no significant difference between the two groups in GCS and NIHSS scores(P>0.05).After operation,the observation group had higher GCS scores and lower NIHSS scores(P<0.05).There was no significant difference in the level of hs-CRP and TNF-αbetween the two groups before operation(P>0.05),and the level of each index in the observation group was lower after operation(P<0.05).The incidence of complications in the observation group was 5.56%,and there was no significant difference compared with 8.57%in the control group(P>0.05).Conclusion Compared with stereotactic hematoma removal,neuroendoscopic hematoma removal for thalamic hemorrhage has more advantages in reducing the amount of hemorrhage,improving the hematoma removal rate,and reducing inflammatory reaction,which is beneficial to reduce the neurological damage of patients and improve the prognosis.

关 键 词：神经内镜 立体定向 血肿清除术 丘脑出血 

分 类 号：R651.1[医药卫生—外科学]