内镜下直切口小骨窗经侧裂入路血肿清除术在基底节脑出血患者中的应用  

Application of endoscopic straight incision small bone window through lateral fissure approach to remove hematoma in patients with basal ganglia hemorrhage

作　　者：熊超 岳学智 Xiong Chao;Yue Xuezhi(The Second People's Hospital of Xinxiang,Henan 45300O)

机构地区：[1]新乡市第二人民医院,河南新乡453000

出　　处：《辽宁医学杂志》2024年第4期41-44,共4页Medical Journal of Liaoning

摘　　要：目的探讨内镜下直切口小骨窗经侧裂入路血肿清除术治疗基底节脑出血患者的临床疗效。方法选取我院2019年11月—2022年5月基底节脑出血患者78例,根据手术入路分为观察组和对照组,各39例。观察组实施内镜下直切口小骨窗经侧裂入路血肿清除术,对照组实施经颞叶皮层入路手术。比较两组血肿清除效果、围术期指标、并发症情况、手术前后神经功能指标[脑源性神经营养因子(BDNF)神经肽Y(NPY)、神经特异性蛋白(S100-β)、神经元特异性烯醇化酶(NSE)]及术后3个月预后情况。结果观察组血肿清除率优于对照组(P<0.05);观察组手术时间、住院时间均短于对照组,术中出血量、治疗费用均少于对照组(P<0.05);两组并发症总发生率(12.82%VS 20.51%)间无显著差异(P>0.05);术后7 d观察组BDNF水平高于对照组,NPY、S100-β、NSE水平低于对照组(P<0.05);术后3个月观察组优良率82.05%高于对照组64.54%(P<0.05)。结论内镜下直切口小骨窗经侧裂入路血肿清除术治疗基底节脑出血患者安全性较高,能优化手术,提高血肿清除效果,有助于神经功能恢复,缩短住院时间,改善患者预后,且能减轻患者经济负担。Objective To investigate the clinical effect of endoscopic straight incision small bone window through lateral fissure approach to remove hematoma in patients with basal ganglia hemorrhage.Methods 78 patients with basal ganglia hemorrhage in our hospital from 2019-11 to 2022-05 were selected and divided into observation group and control group according to the surgical approach,39 cases in each group.The observation group underwent endoscopic straight incision hematoma removal through the small bone window through the lateral fissure approach,and the control group underwent the temporal cortex approach.The results of hematoma clearance,perioperative indexes,complications,neurological function indexes before and after surgery[brain-derived neurotrophic factor(BDNF)neuropeptide Y(NPY),neurospecific protein(S100-β),neuron-specific enolase(NSE)]and prognosis 3 months after surgery were compared between the two groups.Results The hematoma clearance rate of observation group was better than control group(P<0.05).The operation time and hospital stay in the observation group were shorter than those in the control group,and the intraoperative blood loss and treatment cost were shorter than those in the control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups(12.82%VS 20.51%)(P>0.05).The levels of BDNF in the observation group were higher than those in the control group 7 days after surgery,while the levels of NPY,S100-βand NSE were lower than those in the control group(P<0.05).Three months after operation,the excellent and good rate of the observation group was 82.05%higher than that of the control group 64.54%(P<0.05).Conclusion Endoscopic straight incision small bone window through lateral fissile approach hematoma removal in the treatment of patients with basal ganglia hemorrhage is safe,can optimize surgery,improve the effect of hematoma removal,contribute to the recovery of neurological function,shorten the length of hospital stay,improve the prognosis

关 键 词：基底节脑出血 血肿清除术 经侧裂入路 神经功能指标 预后 

分 类 号：R651.12[医药卫生—外科学]