神经内镜辅助下脑出血清除术在自发性脑出血治疗中的应用  

Application of neuroendoscope-assisted cerebral hemorrhage clearance in the treatment of spontaneous cerebral hemorrhage

作　　者：段友强 孙红山 闵有会 DUAN You-qiang;SUN Hong-shan;MIN You-hui(Department of Neurosurgery,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,Henan,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450000

出　　处：《海南医学》2024年第22期3226-3230,共5页Hainan Medical Journal

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20220857)。

摘　　要：目的 比较传统开颅血肿清除术与神经内镜辅助脑出血清除术(NECES)治疗自发性脑出血(ICH)的临床效果。方法 回顾性分析2020年1月至2024年4月郑州大学附属郑州中心医院收治的70例自发性脑出血患者的临床资料,根据手术方式不同分为对照组38例和研究组32例,对照组患者予以传统开放手术治疗,研究组患者予以NECES治疗。治疗结束出院前,比较两组患者的切口长度、骨窗直径、术中出血量、手术时间和ICU住院时间;比较两组患者术前及术后3 d的白细胞、C反应蛋白(CRP)、降钙素原水平;术前及术后1周,比较两组患者的格拉斯哥昏迷量表(GCS)评分;治疗结束出院前,比较两组患者住院期间的并发症发生率。结果 治疗结束出院前,研究组患者的切口长度、骨窗直径分别为(3.29±0.38) cm、(3.93±0.46) cm,明显短于对照组的(8.75±1.18) cm、(10.92±1.39) cm,术中出血量、手术时间及ICU住院时间分别为(35.09±4.15) m L、(1.51±0.20) h、(4.59±0.70) d,明显少于对照组的(475.09±50.88) m L、(3.65±0.39) h、(10.83±1.62) d,差异均有统计学意义(P<0.05)。术前,两组患者的白细胞、CRP、降钙素原比较差异均无统计学意义(P>0.05);术后3 d,两组患者的白细胞、CRP、降钙素原均高于术前,但研究组患者的白细胞、CRP、降钙素原水平分别为(9.11±2.72)×10^(9)/L、(31.59±5.98) mg/L、(0.15±0.02) ng/mL,明显低于对照组的(12.02±4.34)×10^(9)/L、(69.05±8.16) mg/L、(0.32±0.08) ng/mL,差异均有统计学意义(P<0.05)。术前,两组患者的GCS评分比较差异无统计学意义(P>0.05);术后1周,两组患者的GCS评分均高于术前,且研究组患者的GCS评分为(12.96±1.04)分,明显高于对照组的(10.24±1.27)分,差异均有统计学意义(P<0.05)。住院期间,研究组患者的并发症总发生率为6.25%,明显低于对照组的23.68%,差异有统计学意义(P<0.05)。结论 NECES对ICH具有良好的治疗效果,在缩短手术时�Objective To compare the clinical effects of traditional craniotomy and neuroendoscope-assisted intracerebral hemorrhage clearance(NECES)in the treatment of spontaneous intracerebral hemorrhage(ICH).Methods The clinical data of 70 patients with spontaneous ICH admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2020 to April 2024 were retrospectively analyzed.The were divided into a control group(n=38)and a study group(n=32)according to different surgical methods.Patients in the control group were treated with traditional craniotomy,while those in the study group were treated with NECES.Before discharge,the incision length,bone window diameter,intraoperative blood loss,operation duration,and length of ICU stay were compared between the two groups,as well as the levels of white blood cells,C-reactive protein(CRP),and procalcitonin before and at 3 days after operation;the Glasgow Coma Scale(GCS)scores before surgery and at one week after surgery;and the incidence of complications during hospitalization.Results Before discharge,the incision length and bone window diameter in the study group were(3.29±0.38)cm and(3.93±0.46)cm,which were significantly shorter than(8.75±1.18)cm and(10.92±1.39)cm in the control group;the intraoperative blood loss,operation time,and length of ICU stay were(35.09±4.15)mL,(1.51±0.20)h,and(4.59±0.70)d,respectively,which were significantly less than(475.09±50.88)mL,(3.65±0.39)h,and(10.83±1.62)d in the control group;the differences were statistically significant(P<0.05).Before surgery,there was no statistically significant difference in the levels of white blood cells,CRP,and procalcitonin between the two groups of patients(P>0.05).At 3 days after operation,the white blood cells,CRP,and procalcitonin in the two groups were significantly higher than those before operation;the levels in the study group were(9.11±2.72)×10^(9)/L,(31.59±5.98)mg/L,and(0.15±0.02)ng/mL,which were significantly lower than(12.02±4.34)×10^(9)/L,(69.05±8.16)mg/L,and (0.

关 键 词：自发性脑出血 神经内镜 血肿清除术 炎症 并发症 

分 类 号：R743.34[医药卫生—神经病学与精神病学]