超声辅助神经内镜经侧裂入路治疗基底节区高血压脑出血的手术疗效及安全性  

Surgical efficacy and safety of ultrasonic-assisted neuroendoscopy through lateral fissure approach in the treatment of hypertensive cerebral hemorrhage in basal ganglia region

作　　者：高崇丽 陆芳萍 GAO Chong-li;LU Fang-ping(Department of Neurosurgery,The First Affiliated Hospital of China Medical University,Shenyang Liaoning 110001,China)

机构地区：[1]中国医科大学附属第一医院神经外科,辽宁沈阳110001

出　　处：《临床和实验医学杂志》2024年第1期45-49,共5页Journal of Clinical and Experimental Medicine

基　　金：辽宁省自然科学基金(编号:2021FH68)。

摘　　要：目的探究超声辅助神经内镜经侧裂入路治疗基底节区高血压性脑出血的手术疗效及安全性。方法采用回顾性研究方法分析2020年8月至2022年7月在中国医科大学附属第一医院接受治疗的90例基底节区高血压脑出血患者,按治疗方案不同分为观察组和对照组,每组各45例。观察组在超声辅助神经内镜下经侧裂入路治疗,对照组予以经侧裂入路传统小骨窗开颅血肿清除术治疗。比较两组患者的血肿清除率、术中及术后情况、格拉斯哥昏迷量表(GCS)评分、术后并发症发生情况、美国国立卫生研究院卒中量表(NIHSS)评分及日常生活活动能力(ADL)评分。结果观察组患者的血肿清除率为(92.25±2.17)%,明显高于对照组[(83.07±2.55)%],差异有统计学意义(P<0.05)。观察组患者的术中失血量、手术时间、术后血肿残余量、住院时间分别为(92.75±18.96)mL、(95.08±17.58)min、(3.72±0.82)mL、(9.27±1.22)d,均分别低于对照组[(311.68±37.87)mL、(179.29±16.73)min、(8.57±1.69)mL、(14.85±1.59)d],差异均有统计学意义(P<0.05)。观察组患者术后7、15、30 d的GCS分别为(9.62±1.09)、(11.57±1.23)、(13.71±1.57)分,分别高于对照组[(8.98±1.12)、(9.63±1.31)、(11.85±1.63)分],差异均有统计学意义(P<0.05)。观察组患者术后并发症发生率为11.11%,明显低于对照组(28.89%),差异有统计学意义(P<0.05)。观察组患者术后NIHSS评分为(9.85±0.87)分,明显低于对照组[(13.87±0.92)分],术后ADL评分为(66.71±4.78)分,明显高于对照组[(51.23±4.93)分],差异均有统计学意义(P<0.05)。结论经超声辅助神经内镜经侧裂入路治疗基底节区高血压性脑出血可获得满意的血肿清除率,能改善患者意识障碍程度,并促进神经功能恢复,提高患者生活质量,还可缩短手术时间和住院时间,减少术中失血量和后血肿残余量,且治疗安全性较高。Objective To investigate the surgical efficacy and safety of ultrasus-assisted neuroendoscopy in the treatment of hypertensive cerebral hemorrhage in basal ganglia.Methods A retrospective study was conducted to analyze 90 patients with hypertensive cerebral hemorrhage in the basal ganglia region who received treatment in the First Affiliated Hospital of China Medical University from August 2020 to July 2022,and they were divided into two groups according to different treatment plans,with 45 cases in each group.The observation group was treated with ultrasonic-assisted neuroendoscopy via lateral cleat approach.The control group was treated by traditional small bone window craniotomy hematoma removal via lateral fissure approach.Hematoma clearance rate,intraoperative and postoperative conditions,Glasgow coma scale(GCS)score,the occurrence of postoperative complications,National Institute of Health stroke scale(NIHSS)score and Activity of Daily Living(ADL)score were compared between the two groups.Results The hematoma clearance rate of observation group was(92.25±2.17)%,which was significantly higher than that of the control group[(83.07±2.55)%],and the difference was statistically significant(P<0.05).The intraoperative blood loss,operative time,postoperative hematoma residual amount and hospital stay of the observation group were(92.75±18.96)mL,(95.08±17.58)min,(3.72±0.82)mL and(9.27±1.22)d,respectively,which were lower than those of the control group[(311.68±37.87)mL,(179.29±16.73)min,(8.57±1.69)mL and(14.85±1.59)d],respectively,and the differences were statistically significant(P<0.05).The GCS of observation group on 7,15 and 30 days after operation were(9.62±1.09),(11.57±1.23)and(13.71±1.57)points,respectively,which were higher than those of the control group[(8.98±1.12),(9.63±1.31)and(11.85±1.63)points],respectively,and the differences were statistically significant(P<0.05).The postoperative complication rate of the observation group was 11.11%,which was significantly lower than that of the cont

关 键 词：颅内出血 高血压性 超声引导 神经内镜 经侧裂入路 血肿清除术 手术疗效 安全性 

分 类 号：R651.1[医药卫生—外科学]