不同微创手术方法治疗高血压脑出血老年患者的疗效研究  

Study on the Efficacy of Different Minimally Invasive Surgical Methods in Treating Elderly Patients with Hypertensive Cerebral Hemorrhage

作　　者：陈为涛 宋春雷 王言董 CHEN Weitao;SONG Chunlei;WANG Yandong(Department of Neurosurgery,Junan County People's Hospital,Linyi,Shandong Province,276600 China)

机构地区：[1]莒南县人民医院神经外科,山东临沂276600

出　　处：《系统医学》2024年第7期124-126,130,共4页Systems Medicine

摘　　要：目的评价不同微创手术方法治疗高血压脑出血老年患者的效果。方法选取2021年3月—2023年2月莒南县人民医院神经外科收治的117例行微创手术治疗的高血压脑出血老年患者为研究对象,根据随机数表法分为3组,即微创钻孔组(n=39)、立体定向组(n=39)与神经内镜组(n=39)。微创钻孔组、立体定向组与神经内镜组分别给予微创钻孔引流术、立体定向颅内血肿清除术与神经内镜下血肿清除术治疗。比较3组疗效指标、血清指标、简易精神状态评价量表(Mini Mental State Examination,MMSE)评分与自我认同感量表(Self Identity Scale,SIS)评分。结果神经内镜组患者疗效(64.1%)优于立体定向组(56.4%)、微创钻孔组(53.8%),差异有统计学意义(χ^(2)=14.674、25.720,P均<0.05)。治疗2周后,神经内镜组神经营养因子为(6.01±0.69)ng/mL,较其余2组显著提高,差异有统计学意义(P均<0.05);神经内镜组的S-100蛋白为(0.86±0.32)μg/mL、血清铁蛋白为(277.95±19.96)ng/mL,较其余2组显著降低,差异有统计学意义(P均<0.05)。治疗6个月后,神经内镜组的SIS、MMSE评分高于其余2组,差异有统计学意义(P均<0.05)。结论与微创钻孔引流术与立体定向颅内血肿清除术比较,神经内镜下血肿清除术治疗高血压脑出血老年患者的疗效更好。Objective To evaluate the efficacy of different minimally invasive surgical methods in treating elderly patients with hypertensive cerebral hemorrhage.Methods 117 elderly patients with hypertensive cerebral hemorrhage who underwent minimally invasive surgery from March 2021 to February 2023 at the Department of Neurosurgery of Junan County People's Hospital were slected as the study subjects.The patients were divided into three groups according to the random number table method,including the minimally invasive drilling group(n=39),the stereotactic group(n=39)and the neuroendoscopy group(n=39).Minimally invasive drilling drainage,stereotactic intracranial hematoma removal and neuroendoscopic hematoma removal were given to the minimally invasive drilling group,stereotactic group and neuroendoscopy group,respectively.The efficacy indexes,serum indexes,scores of Mini Mental State Examination(MMSE)and Self Identity Scale(SIS)were compared among the three groups.Results The efficacy of patients in the neuroendoscopy group(64.1%)was higher than that in the stereotactic group(56.4%)and minimally invasive drilling group(53.8%),and the differences were statistically significant(χ^(2)=14.674,25.720,both P<0.05).After 2 weeks of treatment,the neurotrophic factor in the neuroendoscopy group was(6.01±0.69)ng/mL,which was significantly higher than the remaining two groups,and the differences were statistically significant(both P<0.05).And the S-100 protein in the neuroendoscopy group was(0.86±0.32)μg/mL and serum ferritin in the neuroendoscopy group was(277.95±19.96)ng/mL,which were significantly lower than the remaining two groups,and the differences were statistically significant(all P<0.05).After 6 months of treatment,SIS and MMSE scores were significantly higher in the neuroendoscopy group compared with the remaining two groups,and the differences were statistically significant(all P<0.05).Conclusion Compared with minimally invasive drilling and drainage and stereotactic intracranial hematoma removal,neuroendoscopic he

关 键 词：高血压 脑出血 微创手术 

分 类 号：R544.1[医药卫生—心血管疾病]