内窥镜下微创手术与钻孔引流术治疗高血压脑出血的临床疗效及对患者头颅CT扫描检查结果的影响  

Clinical efficacy of endoscopic minimally invasive surgery and drilling drainage in the treatment of hypertensive cerebral hemorrhage and the effect on patients'cranial CT scan findings

作　　者：唐世超 张伟 符饶 TANG Shichao;ZHANG Wei;FU Rao(Department of Neurosurgery,Xiangzhou District People's Hospital,Xiangyang,Hubei,441000,China)

机构地区：[1]襄州区人民医院神经外科,湖北襄阳441000

出　　处：《当代医学》2023年第31期83-87,共5页Contemporary Medicine

摘　　要：目的探讨内窥镜下微创手术与钻孔引流术治疗高血压脑出血的临床疗效及对患者头颅CT扫描检查结果的影响。方法选取2019年1月至2021年6月襄州区人民医院收治的92例高血压脑出血患者作为研究对象,按照双盲法分为对照组与研究组,每组46例。对照组行钻孔引流术治疗,研究组行内窥镜下微创手术治疗。比较两组围手术期指标、术后不同时间点CT扫描的血肿残余率、神经功能与生命质量、预后情况、术后并发症发生情况。结果研究组手术时间长于对照组,术中出血量少于对照组,术后引流管留置时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。术后12 h、24 h、1周,研究组头颅CT扫描血肿残余率均低于对照组,差异有统计学意义(P<0.05);术后3个月,两组头颅CT扫描血肿残余率比较差异无统计学意义。术后3个月,两组美国国立卫生研究院卒中量表(NIHSS)评分均低于术前,Barth-el指数均高于术后6 h,且研究组NIHSS评分低于对照组,Barthel指数高于对照组,差异有统计学意义(P<0.05)。两组病死率比较差异无统计学意义;研究组再出血率、并发症发生率均低于对照组,差异有统计学意义(P<0.05)。结论与钻孔引流术相比,内窥镜下微创手术治疗高血压脑出血可快速清除血肿,改善患者神经功能与生命质量,能预防再出血,且安全性较高,值得临床推广应用。Objective To explore the clinical efficacy of endoscopic minimally invasive surgery and drilling drainage in the treatment of hyper-tensive cerebral hemorrhage and the effect on patients'cranial CT scan findings.Methods 92 patients with hypertensive cerebral hemorrhage admit-ted to Xiangzhou District People's Hospital from January 2019 to June 2021 were selected as the study subjects,and they were divided into the con-trol group and the study group according to the double-blind method,with 46 cases in each group.The control group was treated by drilling and drainage,and the study group was treated by endoscopic minimally invasive surgery.The perioperative indexes,residual hematoma rate of CT scan at different postoperative times,neurological function and quality of life,prognosis and postoperative complications were compared between the two groups.Results The operation time in the study group was longer than that in the control group,the intraoperative blood loss was less than that in the control group,and the postoperative drainage tube indwelling time and hospitalization time were shorter than those in the control group,the dif-ferences were statistically significant(P<0.05).At 12 h,24 h and 1 week after operation,the residual hematoma rate of in head CT scan in the study group was lower than that in the control group,and the differences were statistically significant(P<0.05),there was no significant difference in the residual hematoma rate of between the two groups at 3 months after operation.At 3 months after operation,the National Institutes of Health stroke scale(NIHSS)scores of the two groups were lower than those before operation,and the Barthel index was higher than that at 6 h after operation,and the NIHSS score in the study group was lower than that in the control group,and the Barthel index was higher than that in the control group,the differences were statistically significant(P<0.05).There was no significant difference in mortality between the two groups;the rebleeding rate and complication rate in

关 键 词：高血压脑出血 内窥镜下微创手术 钻孔引流术 血肿残余率 神经功能 

分 类 号：R651.12[医药卫生—外科学] R544.1[医药卫生—临床医学]