小脑幕上高血压性脑出血(血肿量20~40 mL)神经内镜下血肿清除术与保守治疗对比分析  

Comparative Analysis of Neuroendoscopic Hematoma Removal Surgery and Conservative Treatment for Hypertensive Intracerebral Hemorrhage Above the Cerebellar Tentorium(Hematoma Volume 20~40 mL)

作　　者：赵帅杰 李亚飞 王昊天 闵有会 张辉 Zhao Shuaijie;Li Yafei;Wang Haotian(Department of Neurosurgery,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou,Henan,450001,China)

机构地区：[1]郑州大学附属郑州中心医院神经外科,河南郑州450001

出　　处：《黑龙江医学》2024年第15期1816-1818,共3页Heilongjiang Medical Journal

摘　　要：目的:探讨小脑幕上高血压性脑出血(HICH)(血肿量20~40 mL)手术治疗与非手术治疗的临床效果。方法:选取2021年10月—2022年12月郑州大学附属郑州中心医院小脑幕上血肿量为20~40 mL的80例患者作为研究对象,随机分为神经内镜组和保守治疗组,每组各40例。评价两组患者治疗后的各项临床指标以及治疗后3个月的美国国立卫生研究院卒中量表(NIHSS)、格拉斯哥昏迷评分法(GOS)评分。结果:神经内镜组平均住院时间、平均住院费用低于保守治疗组,治疗后7 d血肿清除率、GCS评分高于保守治疗组,差异有统计学意义(t=52.943、-8.299、124.397、18.256,P<0.05);神经内镜组治疗后1个月、3个月NIHSS评分低于保守治疗组,治疗后1个月、3个月GOS评分高于保守治疗组,差异有统计学意义(t=3.995、0.218、4.927,P<0.05)。结论:神经内镜下血肿清除术能够改善小脑幕上HICH(血肿量20~40 mL)患者的预后,减少患者住院时间及医疗负担。Objective:To explore the clinical efficacy of surgical and non-surgical treatment for supratentorial cerebral hemorrhage(hematoma volume 20~40 mL).Methods:80 patients with hypertensive intracerebral hemorrhage in the hospital with a supratentorial hematoma volume ranging from 20~40 mL were selected as the study subjects,and randomly divided into two groups:the neuroendoscopic hematoma removal surgery group and the conservative treatment group,with 40 patients in each group.The clinical indicators of both groups after treatment,as well as the NIHSS score and GOS score at 3 months after treatment,were compared.Results:The average hospitalization time and the average hospitalization cost of the neuroendoscopic hematoma removal surgery group were lower than those of the conservative treatment group.The hematoma removal rates and the GCS scores on the 7th day after treatment were higher than those of the conservative treatment group.The NIHSS score of the neuroendoscopy group was lower than that of the conservative treatment group 1 month and 3 months after treatment,and the GOS score was higher than that of the conservative treatment group 1 month and 3 months after treatment,with statistically significant differences(t=3.995,0.218,4.927;P<0.05).Conclusion:Neuroendoscopic hematoma removal surgery can improve the prognosis of patients with hypertensive intracerebral hemorrhage(hematoma volume 20~40 mL),and reduce hospital stay and medical burden.

关 键 词：神经内镜 血肿清除术 高血压性脑出血 小脑幕上 

分 类 号：R651.1[医药卫生—外科学]