接触式成像可视化微创术与传统开颅术治疗幕上高血压脑出血的对比研究  

Comparative study of contact imaging-guided minimally invasive surgery versus traditional craniotomy for supratentorial hypertensive intracerebral hemorrhage

作　　者：张先斌 陈海军 熊雨晗 徐其明 秦荣 张珑 李华泉 喻祥 邓磊 Zhang Xianbin;Chen Haijun;Xiong Yuhan;Xu Qiming;Qin Rong;Zhang Long;Li Huaquan;Yu Xiang;Deng Lei(Department of Neurosurgery,908 Hospital of Joint Logistics Support Force,Nanchang,Jiangxi 330000,China)

机构地区：[1]联勤保障部队908医院神经外科,江西南昌330000

出　　处：《中国微侵袭神经外科杂志》2023年第12期72-76,共5页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的比较接触式成像可视化微创手术和传统开颅手术在治疗幕上高血压脑出血(Hypertensive intracerebral hemorrhage,HICH)患者的近期及长期疗效。方法回顾性分析301例幕上HICH患者病例资料,根据治疗方法进行分组,其中采用接触式成像可视化微创手术(微创组)151例,常规开颅手术治疗(常规组)150例。比较两组患者临床指标、神经功能恢复和术后并发症。结果微创组在手术时间、术中出血量、术后神志恢复和住院时间上均优于常规组(P<0.05)。术后3个月,微创组NIHSS评分低于常规组,ADL评分高于常规组,差异显著具有统计学意义(P<0.05)。微创组术后感染发生率低于常规组(P<0.05)。结论微创手术治疗幕上HICH患者可更快恢复和较少并发症发生,有利于神经功能和生活自理能力提高,但特定情况下开颅手术可能更适宜。Objective To compare the short-term and long-term outcomes of contact imaging-guided minimally invasive surgery(MIS)and traditional craniotomy in the treatment of supratentorial hypertensive intracerebral hemorrhage(HICH).Methods A retrospective analysis was conducted on 301 cases of supratentorial HICH patients,who were divided into two groups based on the treatment approach:151 patients underwent contact imaging-guided minimally invasive surgery(MIS group),and 150 patients underwent conventional craniotomy(conventional group).Clinical indicators,neurological recovery,and postoperative complications were compared between the two groups.Results The MIS group showed superiority over the conventional group in terms of operative time,intraoperative blood loss,postoperative consciousness recovery and hospital stay(P<0.05).At 3 months postoperatively,the MIS group had significantly lower NIHSS scores and higher ADL scores compared to the conventional group,indicating statistically significant differences(P<0.05).Furthermore,the incidence of postoperative infections was lower in the MIS group than in the conventional group(P<0.05).Conclusions Minimally invasive surgery for supratentorial HICH patients can lead to faster recovery and fewer complications,favoring the improvement of neurological function and activities of daily living.However,in specific scenarios,craniotomy may still be the more appropriate treatment option.

关 键 词：脑出血 高血压 幕上 接触式成像可视化微创手术 开颅手术 

分 类 号：R743[医药卫生—神经病学与精神病学]