神经内镜手术治疗高血压脑出血破入脑室的临床效果分析  

Clinical analysis of neuroendoscopic surgery for the treatment of hypertensive intracerebral hemorrhage breaking into the ventricle

作　　者：丹巴 高娃 DAN Ba;GAO Wa(Xing'an League People's Hospital,Ulanhot 137400,China)

机构地区：[1]兴安盟人民医院,137400 [2]兴安盟乌兰浩特市都林社区卫生服务中心内科,137400

出　　处：《中国实用医药》2024年第16期48-51,共4页China Practical Medicine

摘　　要：目的观察高血压脑出血(HICH)破入脑室经神经内镜手术治疗的效果。方法选取HICH破入脑室患者70例,随机分为观察组(经神经内镜手术治疗)与对照组(经常规显微镜下手术治疗),各35例。对比两组血肿清除情况、临床指标、并发症发生情况、美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数、预后情况。结果观察组患者术后1、3、7 d脑室内血肿清除率分别为(59.3±9.7)%、(71.2±15.5)%、(84.4±7.7)%,均高于对照组的(26.4±10.0)%、(51.1±14.4)%、(64.2±8.8)%(P<0.05);两组患者术后1、3、7 d脑实质血肿清除率组间对比无差异(P>0.05)。观察组手术时间为(1.5±0.1)h、出血量为(38.3±4.7)ml、引流时间为(3.6±1.4)d,对照组手术时间为(2.6±0.4)h、出血量为(46.1±5.8)ml、引流时间为(6.1±1.0)d。观察组手术时间、引流时间短于对照组,出血量少于对照组(P<0.05)。观察组并发症发生率8.6%(3/35)低于对照组的28.6%(10/35)(P<0.05)。术后3个月,观察组NIHSS评分为(14.9±2.2)分、Barthel指数为(49.5±3.9)分,对照组NIHSS评分为(18.7±3.7)分、Barthel指数为(43.7±2.9)分,观察组NIHSS评分低于对照组,Barthel指数高于对照组(P<0.05)。观察组预后良好率71.4%(25/35)高于对照组的34.3%(12/35)(P<0.05)。结论神经内镜手术可有效提升HICH破入脑室患者脑室内血肿清除率,改善预后,并发症较少,价值较高。Objective To observe the effect of neuroendoscopic surgery for the treatment of hypertensive intracerebral hemorrhage breaking into the ventricle.Methods 70 patients with HICH breaking into the ventricles were randomly divided into an observation group(neuroendoscopic surgery)and a control group(conventional surgery under microscope),each consisting of 35 cases.The hematoma clearance,clinical indicators,complications,National Institutes of Health Stroke Scale(NIHSS)score,Barthel index and prognosis were compared between the two groups.Results The clearance rate of intraventricular hematoma of the observation group were(59.3±9.7)%,(71.2±15.5)%,and(84.4±7.7)%at 1,3,and 7 d postoperatively,which were higher than(26.4±10.0)%,(51.1±14.4)%,and(64.2±8.8)%of the control group(P<0.05).There was no difference in clearance rate of cerebral parenchymal hematoma at 1,3 and 7 d postoperatively between the two groups(P>0.05).In the observation group,the operation time was(1.5±0.1)h,the blood loss was(38.3±4.7)ml,and the drainage time was(3.6±1.4)d;in the control group,the operation time was(2.6±0.4)h,the blood loss was(46.1±5.8)ml,and the drainage time was(6.1±1.0)d.The operation time and drainage time of the observation group were shorter than those of the control group,and the blood loss was less than that of the control group(P<0.05).The complication rate of 8.6%(3/35)in the observation group was lower than 28.6%(10/35)in the control group(P<0.05).At 3 months postoperatively,the NIHSS score of the observation group was(14.9±2.2)points and the Barthel index was(49.5±3.9)points;the NIHSS score of the control group was(18.7±3.7)points and the Barthel index was(43.7±2.9)points.The NIHSS score of the observation group was lower than that of the control group and the Barthel index was higher than that of the control group(P<0.05).The good prognosis rate of 71.4%(25/35)in the observation group was higher than 34.3%(12/35)in the control group(P<0.05).Conclusion Neuroendoscopic surgery can effectively improve the clea

关 键 词：高血压脑出血 破入脑室 并发症 神经内镜 血肿清除率 预后 临床指标 

分 类 号：R651.1[医药卫生—外科学]