神经内镜手术对高血压脑出血患者神经功能、脑血流动力学的影响  

Effects of Neuroendoscopic Surgery on Neurological Function and Cerebral Hemodynamics in Patients with Hypertensive Cerebral Hemorrhage

作　　者：李凯 明兴[1] 杜海 何晓光[1] 王天男 LI Kai;MING Xing;DU Hai;HE Xiaoguang;WANG Tiannan(Department of Neurosurgery,Xuzhou Central Hospital,Xuzhou 221009 Jiangsu,China)

机构地区：[1]徐州市中心医院神经外科,江苏徐州221009

出　　处：《现代诊断与治疗》2023年第12期1751-1754,共4页Modern Diagnosis and Treatment

基　　金：徐州医科大学附属医院发展基金资助项目(项目编号XVFM2020011)。

摘　　要：目的探讨应用神经内镜手术治疗高血压脑出血(HCH)对患者神经功能及脑血流动力学影响。方法选取2019年1月至2022年2月我院收治的70例HCH患者,采用随机数字表法分为试验组和对照组各35例。对照组采用开颅血肿清除术,试验组采用神经内镜手术。对比两组治疗效果、术前与术后1个月神经功能(NIHSS评分)与日常生活活动能力(ADL评分)、术前与术后7 d脑血流动力学[双侧大脑中动脉与前动脉的平均血流速度(Vm)、收缩期峰值血流速度(Vs)]及术后并发症情况。结果试验组患者总有效率为94.29%,显著高于对照组的77.14%(P<0.05);术后1个月,试验组NIHSS评分显著低于对照组低,ADL评分高于对照组(P<0.05);术后7 d,试验组双侧大脑中动脉与前动脉Vm、Vs指标均高于对照组(P<0.05);试验组术后并发症总发生率为5.71%,低于对照组25.71%(P<0.05)。结论应用神经内镜手术治疗HCH的效果满意,能够调适神经功能,促进日常活动水平提升,并且对于脑部血液循环的有一定调节作用,术后并发症发生率低,值得推广。Objectives To investigate the effect of neuroendoscopic surgery on neurological function and cerebral hemodynamics in patients with hypertensive intracerebral hemorrhage(HCH).Methods A total of 70 HCH patients admitted to our hospital from January 2019 to February 2022 were selected and divided into experimental group and control group randomly,with 35 cases in each group.The control groupreceived craniotomy hematoma removal,and the experimental group received neuroendoscopic surgery.The therapeutic effect,neurological function(NIHSS score)and activities of daily living(ADL score)before and 1 month after surgery,cerebral hemodynamics(mean blood flow velocity(Vm)and peak systolic blood flow velocity(Vs)of bilateral middle cerebral artery and anterior cerebral arteries)before and 7 days after operation,and postoperative complications were compared between the two groups.Results The total effective rate of the experimental group was 94.29%,which was significantly higher than the 77.14%of the control group(P<0.05).One month after operation,the NIHSS score in the experimental group was significantly lower than that in the control group,and the ADL score in the experimental group was significantly higher than that in the control group(P<0.05).The Vm and Vs indexes of bilateral middle cerebral artery and anterior cerebral artery in experimental group were significantly higher than those in control group 7 days after surgery(P<0.05).The total incidence of postoperative complications in the experimental group was 5.71%,which was significantly lower than 25.71%in the control group(P<0.05).Conclusions Neuroendoscopic surgery in the treatment of HCH achieves satisfactory results,which can adjust the nerve function,promote the improvement of daily activity level,and has a certain regulating effect on the brain blood circulation.The incidence of postoperative complications is low,which is worthy of promotion.

关 键 词：神经内镜手术 开颅血肿清除术 高血压脑出血 

分 类 号：R743.34[医药卫生—神经病学与精神病学]