冠状缝前入路神经内镜手术与外侧裂入路开颅手术治疗基底节区高血压脑出血的效果比较  

Comparison of therapeutic effects of anterior coronal suture neuroendoscopic surgery and lateral fissure craniotomy surgery on hypertensive intracerebral hemorrhage in the basal ganglia region

作　　者：申学明[1] 何超[1] 张天祥[1] 冯要钦 常波 Shen Xueming;He Chao;Zhang Tianxiang;Feng Yaoqin;Chang Bo(Department of Neurosurgery,Anyang People’s Hospital,Anyang 455000,China)

机构地区：[1]安阳市人民医院神经外科,安阳455000

出　　处：《中国实用医刊》2024年第9期6-9,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较冠状缝前入路神经内镜手术与外侧裂入路开颅手术治疗基底节区高血压脑出血(HICH)的临床疗效。方法回顾性抽取2021年6月至2023年6月安阳市人民医院收治的基底节区HICH患者78例,依据手术入路分为对照组和观察组,每组39例。对照组给予外侧裂入路开颅手术,观察组给予冠状缝前入路神经内镜手术。比较两组手术指标和预后指标。结果观察组手术时间短于对照组,术中出血量、术后6 h血肿余量少于对照组(P<0.05)。观察组ICU入住时间短于对照组,术后3 d颅内压、美国国立卫生研究院卒中量表评分低于对照组,术后3 d Barthel评分高于对照组(P<0.05);两组半年期疾病复发率比较,差异未见统计学意义(P>0.05)。结论与外侧裂入路开颅手术比较,冠状缝前入路神经内镜手术治疗基底节区HICH手术时间短,术中失血量、术后血肿余量少,ICU入住时间短,有助于短期内改善患者的颅内压、神经功能和生活自理能力,且术后半年疾病复发率低。Objective To compare the therapeutic effects of anterior coronal suture neuroendoscopic surgery and lateral fissure craniotomy surgery on hypertensive intracerebral hemorrhage(HICH)in the basal ganglia region.Methods A total of 78 patients with HICH in the basal ganglia admitted to Anyang People’s Hospital from June 2021 to June 2023 were retrospectively selected,and they were divided into a control group and an observation group according to the surgical approach,with 39 cases in each group.The control group was treated by craniotomy via lateral fissure approach,and the observation group was treated by neuroendoscopic surgery via anterior coronal suture approach.The surgical indexes and prognostic indicators were compared between the two groups.Results The operation time of the observation group was shorter than that of the control group,while the intraoperative blood loss and 6-hour postoperative hematoma residual were lower than those of the control group(P<0.05).The length of intensive care unit(ICU)stay in the observation group was shorter than that in the control group(P<0.05).The intracranial pressure and National Institute of Health stroke scale score in the observation group were lower than those in the control group,while the Barthel score was higher than that in the control group 3 days after surgery(P<0.05).There was no significant difference in the recurrence rate of disease within 6 months after surgery between the two groups(P>0.05).Conclusions Compared with craniotomy via lateral fissure approach,neuroendoscopic surgery via anterior coronal approach in the treatment of HICH in the basal ganglia region has a short operation time,less intraoperative blood loss,less postoperative hematoma residual,and shorter ICU stay.It is conductive to improving the patient’s intracranial pressure,neurological function and self-care ability in the short term,with a low disease recurrence rate within 6 months after surgery.

关 键 词：脑出血 基底节区 高血压 冠状缝前入路 神经内镜 外侧裂入路 

分 类 号：R651.1[医药卫生—外科学]