神经内镜下小骨窗与微创软通道在高血压脑出血治疗中的效果及患者预后对比  

Comparison of the effects and patient prognosis of small bone window and minimally invasive soft channel under neuroendoscopy in the treatment of hypertensive intracerebral hemorrhage

作　　者：陈璞 Chen Pu(Lianjiang People's Hospital,Zhanjiang,Guangdong 524400,China)

机构地区：[1]广东省廉江市人民医院,广东湛江524400

出　　处：《首都食品与医药》2024年第7期40-43,共4页Capital Food Medicine

基　　金：湛江市科技计划项目(项目编号:2023B01154)。

摘　　要：目的分析在高血压脑出血患者中分别采用神经内镜下小骨窗、微创软通道治疗的效果及对预后的影响。方法从廉江市人民医院2021年3月-2023年3月诊疗的高血压脑出血患者中选取68例作为观察对象,根据住院号的单双数分为对照组和观察组,每组各34例,其中对照组采用微创软通道引流术治疗,观察组采用神经内镜下小骨窗血肿清除术治疗。对比两组治疗前后的炎症指标[超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)]、格拉斯哥预后评分(GOS),同时统计两组的手术相关数据、血肿残留率、再出血发生率和并发症发生率。结果治疗后,对照组的hs-CRP为(6.64±1.25)mg/ml、TNF-α为(40.31±3.68)pg/ml,均低于观察组的(7.93±1.67)mg/ml、(43.45±5.21)pg/ml(P<0.05);观察组的手术时间为(45.35±9.74)min,长于对照组的(36.86±9.22)min,观察组的出血量为(34.25±6.38)ml,多于对照组的(30.38±4.51)ml,观察组的甘露醇用量为(275.67±45.16)ml、术后颅内压为(20.29±2.26)mmHg,均低于对照组的(312.62±50.85)ml、(22.21±2.34)mmHg(P<0.05);观察组的GOS评分为(4.21±0.36)分,与对照组的(4.13±0.47)分相比无明显差异(P>0.05);对照组的血肿残留率及再出血发生率分别为17.65%、23.53%,与观察组的0.00%、2.94%相比较高(P<0.05);观察组的并发症发生率为11.76%,与对照组的17.65%相比无明显差异(P>0.05)。结论对于高血压脑出血患者而言,神经内镜下小骨窗血肿清除术与微创软通道引流术均具有一定的治疗效果,其中,微创软通道引流术的手术时间较短,出血量较少,术后的炎症反应相对较轻;神经内镜下小骨窗血肿清除术的血肿残留率和再出血发生率均较低;二者在改善预后和减少并发症发生方面的效果均无明显差异。Objective To analyze the effects of endoscopic small bone window and minimally invasive soft channel therapy on the prognosis of hypertensive intracerebral hemorrhage patients.Method 68 hypertensive intracerebral hemorrhage patients diagnosed and treated in the hospital from March 2021 to March 2023 were selected as the subjects.They were divided into a control group and an observation group based on the odd or even number of hospitalization numbers,with 34 cases in each group.The control group was treated with minimally invasive soft channel drainage surgery,while the observation group was treated with small bone window hematoma removal surgery under neuroendoscopy.Comparison of inflammatory markers before and after treatment between two groups:hypersensitive C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α),the Glasgow Outcome Scale(GOS)was used to analyze surgical related data,residual hematoma rate,incidence of rebleeding,and incidence of complications for both groups.Results After treatment,the hs-CRP of the control group was(6.64±1.25)mg/ml,TNF-α(40.31±3.68)pg/ml,both lower than the observation group's(7.93±1.67)mg/ml and(43.45±5.21)pg/ml(P<0.05);the surgical time of the observation group was(45.35±9.74)minutes,which was longer than the control group's(36.86±9.22)minutes.The bleeding volume of the observation group was(34.25±6.38)ml,which was more than the control group's(30.38±4.51)ml.The amount of mannitol used in the observation group was(275.67±45.16)ml,and the postoperative intracranial pressure was(20.29±2.26)mmHg,both lower than the control group's(312.62±50.85)ml and(22.21±2.34)mmHg(P<0.05);the GOS score of the observation group was(4.21±0.36),and there was no significant difference compared to the control group's(4.13±0.47)score(P>0.05);the residual rate of hematoma and the incidence of rebleeding in the control group were 17.65%and 23.53%,respectively,which were higher than the observation group's 0.00% and 2.94% (P<0.05);the incidence of complications in the observatio

关 键 词：高血压脑出血 微创软通道引流术 神经内镜下小骨窗血肿清除术 神经功能 

分 类 号：R743.34[医药卫生—神经病学与精神病学]