神经内镜微创手术在高血压脑出血中的应用  

Application of minimally invasive neuroendoscopic surgery in hypertensive intracerebral hemorrhage

作　　者：孟艳举[1] 王路[2] 郝志勇[1] 王献清[1] MENG Yanju;WANG Lu;HAO Zhiyong;WANG Xianqing(Neurosurgery,Puyang People′s Hospital,Puyang 457001,China;Anesthesia,Puyang People′s Hospital,Puyang 457001,China)

机构地区：[1]濮阳市人民医院神经外科,河南濮阳457001 [2]濮阳市人民医院麻醉科,河南濮阳457001

出　　处：《华夏医学》2023年第4期93-97,共5页Acta Medicinae Sinica

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210934)。

摘　　要：目的:探讨神经内镜微创手术治疗高血压脑出血(HICH)患者的临床效果。方法:选取94例HICH患者作为研究对象,采用随机数字表法将其分为内镜组和引流组,每组47例。内镜组行神经内镜微创手术,引流组行微创穿刺引流术。比较两组手术相关指标、手术前后炎性因子、神经功能及并发症。结果:内镜组手术时间长于引流组,脑脊液恢复时间、住院时间均短于引流组,差异有统计学意义(P<0.05)。术后1周内镜组C反应蛋白(CRP)、血沉(ESR)、降钙素原(PCT)、白细胞介素-6(IL-6)、胶质纤维酸性蛋白(GFAP)、神经元特异性烯醇化酶(NSE)的水平均低于引流组,神经生长因子(NGF)水平高于引流组(P<0.05)。两组血肿清除率、并发症总发生率比较,差异均无统计学意义(P>0.05)。结论:神经内镜微创手术治疗HICH能减轻炎性反应及神经功能损伤,有助于术后早期恢复,安全性较高。Objective:To investigate the clinical effect of minimally invasive neuroendoscopic surgery for hypertensive intracerebral hemorrhage(HICH).Methods:94 patients with HICH were selected as the study subjects and divided into the endoscopic group and drainage group according to random number table method,with 47 patients in each group.The endoscopic group received minimally invasive neuroendoscopic surgery,while the drainage group received minimally invasive puncture drainage.The operation related indexes,inflammatory factors before and after surgery,nerve function and complications were compared between the two groups.Results:The operation time in the endoscopic group was longer than that in the drainage group,and the recovery time and hospitalization time of cerebrospinal fluid were shorter than those in the drainage group,with statistically significant differences(P<0.05).One week after operation,the levels of C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),procalcitonin(PCT),interleukin-6(IL-6),glial fibrillary acidic protein(GFAP),neuron specific Enolase(NSE)in the endoscopic group were lower than those in the drainage group,and the levels of naver growth factor(NGF)were higher than those in the drainage group(P<0.05).There was no statistically significant difference in hematoma clearance rate and total incidence of complications between the two groups(P>0.05).Conclusion:Minimally invasive neuroendoscopic surgery for HICH can reduce inflammatory reactions and neurological damage,facilitate early postoperative recovery,and has high safety.

关 键 词：高血压脑出血 神经内镜 穿刺引流术 炎性因子 神经功能 

分 类 号：R743.2[医药卫生—神经病学与精神病学]