神经内镜下血肿清除术与小骨窗微创手术治疗高血压性脑出血的临床疗效  

Clinical efficacy of neuroendoscopic hematoma evacuation and small bone window minimally invasive surgery in the treatment of hypertensive intracerebral hemorrhage

作　　者：徐东[1] 王吉锋[1] 王立有[1] 原劲松[1] XU Dong;WANG Jifeng;WANG Liyou;YUAN Jinsong(Department of Neurosurgery,Zhuanghe Central Hospital,Dalian,Liaoning,116400,China)

机构地区：[1]庄河市中心医院神经外科,辽宁大连116400

出　　处：《当代医学》2022年第30期92-94,共3页Contemporary Medicine

摘　　要：目的探究神经内镜下血肿清除术与小骨窗微创血肿清除术治疗高血压性脑出血的临床疗效。方法选取2020年5月至2021年5月本院收治的90例高血压性脑出血患者作为研究对象,按照手术方法不同分为两组,每组45例。开窗组采用小骨窗微创手术治疗,内镜组采用神经内镜下血肿清除术治疗,比较两组术后不良反应发生情况、术前血肿总量、术后血肿周围总量及残余血肿量、手术前后美国国立卫生研究院卒中量表(NIHSS)及微型营养自评量表(MNA)、术后30 d日常生活能力评定量表(ADL)。结果内镜组术后不良反应发生率为2.22%,低于开窗组的15.56%,差异有统计学意义(P<0.05)。两组术前血肿总量比较差异无统计学意义;内镜组血肿周围总量、残余血肿量均少于开窗组,差异有统计学意义(P<0.05)。术前,两组NIHSS、MNA评分比较差异均无统计学意义;术后,两组NIHSS评分均低于术前,MNA评分均高于治疗前,且内镜组NIHSS评分低于开窗组,MNA评分高于开窗组,差异有统计学意义(P<0.05)。术后30 d,内镜组进食、洗澡、修饰、穿衣、大便控制、小便控制、如厕、床椅转移、上下楼梯、行走评分及总分均高于开窗组,差异有统计学意义(P<0.05)。结论与小骨窗微创手术比较,神经内镜下血肿清除术治疗高血压性脑出血的临床疗效更佳,可更好地清除脑部血肿,改善患者神经功能,提高其日常生活能力,值得临床推广应用。Objective To investigate the clinical efficacy of neuroendoscopic hematoma evacuation and small bone window minimally invasive surgery in the treatment of hypertensive intracerebral hemorrhage.Methods A total of 90 patients with hypertensive cerebral hemorrhage admitted to our hospital from May 2020 to May 2021 were selected as the research subjects,and they were divided into two groups according to different surgical methods,with 45 cases in each group.The fenestration group was treated with small bone window minimally invasive surgery,and endoscopic group was treated with neuroendoscopic hematoma evacuation,and the occurrence of postoperative adverse reactions,the total amount of preoperative hematomas,the total amount of postoperative hematomas and residual hematomas,the National Institute of Health stroke scale(NIHSS)and micro-nutrition self-rating scale(MNA)before and after surgery,and the daily living ability rating scale(ADL)for 30 d after surgery were compared between the two groups.Results The total incidence of postoperative adverse reactions in the endoscopic group was 2.22%,which was lower than 15.56%in the fenestration group,and the difference was statistically significant(P<0.05).There was no significant difference in the total number of preoperative hematomas between the two groups;the total amount of hematoma around and residual hematoma in the endoscopic group were lower than those in the fenestration group,and the difference was statistically significant(P<0.05).Before surgery,there was no significant difference in NIHSS and MNA scores between the two groups;after surgery,the NIHSS scores of the two groups were lower than those before treatment,and the MNA scores were higher than those before treatment,and the NIHSS score of endoscopic group was lower than that of the fenestration group,and the MNA score was higher than that of the fenestration group,and the difference was statistically significant(P<0.05).At 30 d after surgery,the scores of eating,bathing,modification,dressing,stool control,uri

关 键 词：高血压性脑出血 神经内镜血肿清除术 小骨窗微创手术 

分 类 号：R651.12[医药卫生—外科学]