经额导航辅助神经内镜下血肿清除术与经颞小骨窗开颅显微镜下血肿清除术治疗基底核脑出血的疗效比较  

Comparison of Efficacy between Transfrontal Navigation-Assisted Neuroendoscopic Remove Hematoma and Transtemporal Small Bone Window Craniotomy Microsurgery Remove Hematoma in the Treatment of Basal Ganglia Intracerebral Hemorrhage

作　　者：张清超 查正江[1] 李志宏[1] 周和平[1] 唐剑 ZHANG Qingchao;ZHA Zhengjiang;LI Zhihong;ZHOU Heping;TANG Jian(Department of Neurosurgery,Anqing Municipal Hospital,Anqing 246003,China)

机构地区：[1]安徽省安庆市立医院神经外科,246003

出　　处：《实用心脑肺血管病杂志》2024年第8期113-117,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：安徽省科技重大专项(201903a07020006);安徽医科大学附属安庆医学中心自然科学项目(2022aqykj03)。

摘　　要：目的比较经额导航辅助神经内镜下血肿清除术与经颞小骨窗开颅显微镜下血肿清除术治疗基底核脑出血的疗效。方法回顾性选取2022年1月—2023年5月安庆市立医院神经外科收治的69例基底核脑出血患者为研究对象,根据手术方式将患者分为导航内镜组(n=34)和开颅显微镜组(n=35)。导航内镜组患者接受经额导航辅助神经内镜下血肿清除术,开颅显微镜组患者接受经颞小骨窗开颅显微镜下血肿清除术。比较两组手术时间、血肿清除率、术中气管切开率、术后再出血率、术后癫痫发生率、术后脑梗死发生率、住院时间,术前及术后第1、14天格拉斯哥昏迷量表(GCS)评分,Barthel指数、预后良好率、死亡率。结果导航内镜组手术时间、住院时间短于开颅显微镜组,血肿清除率高于开颅显微镜组,术中气管切开率低于开颅显微镜组(P<0.05)。干预方法与时间在GCS评分上存在交互作用(P<0.05),干预方法、时间在GCS评分上主效应显著(P<0.05);术后第1、4天导航内镜组GCS评分高于开颅显微镜组(P<0.05)。导航内镜组Barthel指数、预后良好率高于开颅显微镜组(P<0.05)。结论与经颞小骨窗开颅显微镜下血肿清除术相比,经额导航辅助神经内镜下血肿清除术可缩短基底核脑出血患者手术时间、住院时间,提高血肿清除率,减轻意识障碍程度,提高日常生活活动能力及改善预后。Objective To compare the efficacy between transfrontal navigation-assisted neuroendoscopic remove hematoma and transtemporal small bone window craniotomy microsurgery remove hematoma in the treatment of basal ganglia intracerebral hemorrhage.Methods A total of 69 patients with basal ganglia intracerebral hemorrhage admitted to Anqing Municipal Hospital from January 2022 to May 2023 were retrospectively selected as the research subjects.The patients were divided into navigation endoscopy group(n=34)and craniotomy microscope group(n=34)based on the surgical method.Patients in the navigation endoscopy group underwent transfrontal navigation-assisted neuroendoscopic remove hematoma,patients in the craniotomy microscope group underwent transtemporal small bone window craniotomy microsurgery remove hematoma.Surgical duration,hematoma clearance rate,surgical tracheotomy rate,postoperative rebleeding rate,postoperative incidenc of epilepsy,postoperative incidenc of cerebral infarction,hospital stay,Glasgow Coma Scale(GCS)score before operation,and on the 1st and 14th days after operation,Barthel Index,good prognosis rate,and mortality were compared between the two groups.Results Surgical duration and hospital stay in navigation endoscopy group were shorter than those in craniotomy microscope group,hematoma clearance rate was higher than that in craniotomy microscope group,surgical tracheotomy rate was lower than that in craniotomy microscope group(P<0.05).There was an interaction between intervention method and time on GCS score(P<0.05),both intervention method and time produced significant main effects on GCS score(P<0.05);on the 1st and 14th days after operation,the GCS score in navigation endoscopy group was higher than that in craniotomy microscope group(P<0.05).Barthel Index,good prognosis rate in navigation endoscopy group were higher than those in craniotomy microscope group(P<0.05).Conclusion Compared with transtemporal small bone window craniotomy microsurgery remove hematoma,transfrontal navigation-assisted neu

关 键 词：脑出血 基底神经节出血 显微外科手术 神经内窥镜检查 治疗结果 

分 类 号：R743.34[医药卫生—神经病学与精神病学]