硬质神经内镜辅助血肿清除术与双孔冲洗引流术治疗分隔型慢性硬膜下血肿的临床效果对比  

Comparison of Clinical Effects between Rigid Neuroendoscopy Assisted Hematoma Removal Surgery and Double Hole Irrigation and Drainage Surgery in the Treatment of Separated Chronic Subdural Hematoma

作　　者：林建滨 LIN Jianbin(Xiamen Fifth Hospital,Fujian Province,Xiamen 361101,China)

机构地区：[1]福建省厦门市第五医院,福建厦门361101

出　　处：《中国医学创新》2023年第17期46-50,共5页Medical Innovation of China

摘　　要：目的:探讨硬质神经内镜辅助血肿清除术与双孔冲洗引流术治疗分隔型慢性硬膜下血肿的临床效果。方法:回顾性分析2019年1月-2022年12月厦门市第五医院收治的69例分隔型慢性硬膜下血肿患者情况,将采用硬质神经内镜辅助血肿清除术治疗的31例患者作为研究组,采用双孔冲洗引流术治疗的38例患者作为对照组。比较两组治疗相关指标、神经功能指标、日常生活能力及术后并发症情况。结果:研究组中线移位少于对照组,引流时间、住院时间均短于对照组,手术时间长于对照组,血肿清除率高于对照组,差异均有统计学意义(P<0.05)。术后30 d时两组中枢神经特异蛋白S100β水平均低于术前,且研究组低于对照组,差异均有统计学意义(P<0.05)。术后30 d两组ADL评分均高于术前,且研究组高于对照组,差异均有统计学意义(P<0.05)。术后30 d两组CSS评分均低于术前,且研究组低于对照组,差异均有统计学意义(P<0.05)。研究组积气、积液、血肿复发、感染发生率均低于对照组,差异均有统计学意义(P<0.05)。两组癫痫、脑实质损伤发生率的差异均无统计学意义(P>0.05)。结论:硬质神经内镜辅助血肿清除术治疗分隔型慢性硬膜下血肿相较于双孔冲洗引流术而言,可更好地清除血肿,改善神经功能和日常生活能力,降低并发症风险。Objective:To explore the clinical effects of rigid neuroendoscopy assisted hematoma removal surgery and double hole irrigation and drainage surgery in the treatment of separated chronic subdural hematoma.Method:A retrospective analysis was analyzed on 69 patients with partitioned chronic subdural hematoma admitted to Xiamen Fifth Hospital from January 2019 to December 2022.A total of 31 patients treated with rigid neuroendoscopic assisted hematoma removal surgery were selected as the study group,and 38 patients treated with double hole irrigation and drainage surgery were selected as the control group.The related therapeutic indicators,neurological function indicators,daily living ability,and postoperative complications the two groups were compared.Result:The midline displacement in the study group was less than that in the control group,and the drainage time and hospitalization time were shorter than those in the control group,the surgical time was longer than that in the control group,and the hematoma clearance rate was higher than that in the control group,the differences were significant(P<0.05).The levels of central nervous system specific protein S100βin two groups at 30 days after surgery were all lower than those before surgery,and the study group was lower than that of the control group(P<0.05).30 days after surgery,the ADL scores of both groups were higher than those before surgery,and the study group was higher than that of the control group(P<0.05).30 days after surgery,the CSS scores of both groups were lower than those before surgery,and the study group was lower than that of the control group(P<0.05).The incidence of pneumatosis,fluid accumulation,hematoma recurrence,and infection in the study group were lower than those in the control group(P<0.05).There were no statistically significant differences in the incidences of epilepsy and brain parenchymal injury between the two groups(P>0.05).Conclusion:Compared to double hole irrigation and drainage surgery,rigid neuroendoscopy assisted hematoma remo

关 键 词：分隔型慢性硬膜下血肿 硬质神经内镜 血肿清除术 神经功能 日常生活能力 

分 类 号：R651.1[医药卫生—外科学]