经神经内窥镜微创术与微创引流术治疗脑出血的疗效对比及预后影响因素分析  

Analysis on the comparison of therapeutic effects of neuroendoscopic minimally invasive surgery and minimally invasive drainage,and the influence factors of the prognosis in treating cerebral hemorrhage

作　　者：程浩[1] 徐昌林 蔡强[2] 刘娜[1] 陈晟[1] 李毅[1] 高涢 CHENG Hao;XU Chang-lin;CAI Qiang(Department of Neurosurgery,Gezhouba Central Hospital of Sinopharm,The Third Clinical Medical College of China Three Gorges University,Yichang 443002,China;不详)

机构地区：[1]三峡大学第三临床学院国药葛洲坝中心医院神经外科,湖北宜昌443002 [2]武汉大学人民医院神经外科,湖北武汉430060

出　　处：《中国医学装备》2023年第7期41-45,共5页China Medical Equipment

基　　金：国家自然科学基金(81971158)“大鼠脑出血抽吸并神经干细胞移植模型的建立及联合多功能PLGA纳米粒子治疗脑出血的研究”。

摘　　要：目的:探讨经神经内窥镜微创术与微创引流术治疗脑出血的疗效对比及预后影响因素。方法:选取医院收治的124例脑出血患者,依据治疗方法的不同将其分为对照组和观察组,每组62例。对照组接受微创引流术治疗,观察组接受神经内窥镜微创术治疗。比较两组患者围术期相关指标、术后并发症以及随访6个月时的预后情况;采用多因素Logistic回归分析,探讨影响患者术后预后的危险因素。结果:观察组患者的手术时间、术中出血量、血肿清除时间及住院时间明显少于对照组,血肿清除率高于对照组,差异有统计学意义(t=11.198,t=14.455,t=8.410,t=14.219,t=6.909;P<0.05);对照组术后并发症发生率高于观察组,两组比较差异有统计学意义(x^(2)=5.153,P<0.05);观察组预后良好率高于对照组,两组预后良好率比较差异有统计学意义(x^(2)=4.159,P<0.05)。多因素Logistic回归分析结果显示,病程>24 h、破入脑室、入院时美国国立卫生院卒中量表(NIHSS)评分>20分以及微创引流术是脑出血患者预后不良危险因素(OR=2.49,OR=2.38,OR=2.79,OR=2.65;P<0.05)。结论:脑出血患者采用神经内窥镜微创术治疗与微创引流术相比,其临床效果显著,能够有效改善患者围术期相关指标,减少术后并发症发生,且患者预后更好。Objective:To explore the comparison of therapeutic effects of neuroendoscopic minimally invasive surgery and minimally invasive drainage,and the influence factors of the prognosis in treating cerebral hemorrhage.Methods:The clinical data of 124 patients with cerebral hemorrhage admitted to our hospital were selected,and they were divided into control group and observation group according to the different treatment methods,with 62 cases in each group.The control group received minimally invasive drainage,and the observation group received neuroendoscopic minimally invasive surgery.The perioperative related indicators,postoperative complications and the prognosis at the 6th month of follow-up of two groups were compared,and the multivariate Logistic regression analysis was adopted to explore the risk factors affecting the postoperative prognosis of patients.Results:The operation time,the intraoperative blooding volume,the time of hematoma clearance and the time of hospital stay of the observation group were significantly shorter than those of control group,while the rate of hematoma clearance of former was significantly higher than that of the control group(t=11.198,t=14.455,t=8.410,t=14.219,t=6.909,P<0.05),respectively.The incidence of postoperative complications of the control group was significantly higher than that of the observation groups(x^(2)=5.153,P<0.05).The good prognosis rate of the observation group was significantly higher than that of the control group(x^(2)=4.159,P<0.05).The results of multivariate Logistic regression analysis showed that“disease duration>24 h”,“rupture into the ventricle”,“the score of national institute of health stroke scale(NIHSS)at admission>20”and minimally invasive drainage were respectively the risk factors of poor prognosis of patients with cerebral hemorrhage(OR=2.49,OR=2.38,OR=2.79,OR=2.65,P<0.05).Conclusion:Compared with minimally invasive drainage,neuroendoscopic minimally invasive surgery has significant clinical effects for patients with cerebral hemorrhag

关 键 词：脑出血 神经内窥镜微创术 微创引流术 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]