改良Kronlein定位法的神经内镜手术与小骨窗血肿清除术治疗高血压脑出血的效果比较  

Comparison of the effects of neuroendoscopic surgery with modified Kronlein localization method and small bone window hematoma removal in the treatment of hypertensive cerebral hemorrhage

作　　者：孔德军 苗海军 薛世斌 马兵博 乔楠 陈伟[2] KONG Dejun;MIAO Haijun;XUE Shibin;MA Bingbo;QIAO Nan;CHEN Wei(Xi'an Fengcheng Hospital,Xi'an 710016;the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安凤城医院,陕西西安710016 [2]西安交通大学第一附属医院,陕西西安710061

出　　处：《临床医学研究与实践》2023年第21期49-52,共4页Clinical Research and Practice

摘　　要：目的比较改良Kronlein定位法的神经内镜手术与小骨窗血肿清除术治疗高血压脑出血的效果。方法选取2020年7月至2021年7月在本院接受治疗的76例高血压脑出血患者作为研究对象,依据不同术式分为对照组和观察组,各38例。对照组行小骨窗血肿清除术治疗,观察组行改良Kronlein定位法的神经内镜手术治疗。比较两组的治疗效果。结果观察组的手术用时、入住重症监护病房(ICU)时间及住院时长短于对照组,术中出血量少于对照组(P<0.05)。观察组的血肿清除率高于对照组(P<0.05)。术后24 h,观察组的脑水肿体积、颅内压低于对照组(P<0.05)。术后12 h,观察组的皮质醇(Cor)、促肾上腺皮质激素(ACTH)水平均低于对照组(P<0.05)。术后14 d,观察组的美国国立卫生研究院卒中量表(NIHSS)评分低于对照组,日常生活活动能力量表(ADL)评分高于对照组(P<0.05)。结论与小骨窗血肿清除术比较,改良Kronlein法的神经内镜手术治疗高血压脑出血的效果更优,且应激反应轻,患者术后神经及活动功能恢复效果良好。Objective To compare the effects of neuroendoscopic surgery with modified Kronlein localization method and small bone window hematoma removal in the treatment of hypertensive cerebral hemorrhage.Methods A total of 76 patients with hypertensive cerebral hemorrhage who were treated in our hospital from July 2020 to July 2021 were selected as the research objects.According to different surgical methods,the patients were divided into control group and observation group,with 38 cases in each group.The control group was treated with small bone window hematoma removal,and the observation group was treated with neuroendoscopic surgery with modified Kronlein localization method.The therapeutic effects of the two groups were compared.Results The operation time,intensive care unit(ICU)stay time and hospitalization time of the observation group were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group(P<0.05).The hematoma clearance rate of the observation group was higher than that of the control group(P<0.05).At 24 h after operation,the volume of cerebral edema and intracranial pressure in the observation group were lower than those in the control group(P<0.05).At 12 h after operation,the levels of cortisol(Cor)and adrenocorticotropic hormone(ACTH)in the observation group were lower than those in the control group(P<0.05).At 14 d after operation,the National Institute of Health Stroke Scale(NIHSS)score of the observation group was lower than that of the control group,and the Activity of Daily Living Scale(ADL)score was higher than that of the control group(P<0.05).Conclusion Compared with small bone window hematoma removal,neuroendoscopic surgery with modified Kronlein localization method is more effective in the treatment of hypertensive cerbral hemorrhage,and has light stress response and good recovery effect of nerve and activity function after operation.

关 键 词：改良Kronlein定位法 神经内镜手术 小骨窗血肿清除术 高血压脑出血 

分 类 号：R743.2[医药卫生—神经病学与精神病学]