神经内镜下脑血肿清除术与小骨窗开颅清除术治疗高血压脑出血的有效性及安全性分析  

Analysis of the Efficacy and Safety of Neuroendoscopic Brain Hematoma Removal and Small Bone Window Craniotomy in the Treatment of Hypertensive Cerebral Hemorrhage

作　　者：张学基[1] 卫明[1] 孙静波[1] 李殿炜 郭树铭 李青霞 ZHANG Xueji;WEI Ming;SUN Jingbo;LI Dianwei;GUO Shuming;LI Qingxia(Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou,Gansu,730050,China)

机构地区：[1]甘肃省中医院,甘肃兰州730050

出　　处：《中外医疗》2024年第32期46-49,共4页China & Foreign Medical Treatment

摘　　要：目的探讨高血压脑出血患者分别采用小骨窗开颅清除术(以下简称为“小骨术”)和神经内镜下脑血肿清除术(以下简称“内镜术”)治疗的临床效果和安全性。方法随机选取2019年5月—2023年5月甘肃省中医院收治的80例高血压脑出血患者作为研究对象,依据不同的手术方式将观察对象分为两组,各40例。对照组采用小骨术治疗,观察组采用内镜术治疗,对比两组的治疗效果、神经功能缺损程度、神经功能恢复状态、意识状态和并发症发生情况。结果观察组术中出血量少于对照组,手术时间和住院时间均短于对照组,差异有统计学意义(P均<0.05)。出院时,观察组美国国立卫生研究院卒中量表评分、改良Rankin量表评分均低于对照组,格拉斯哥昏迷评分高于对照组,差异有统计学意义(P均<0.05)。观察组的并发症发生率为2.50%(1/40),低于对照组的20.00%(8/40),差异有统计学意义(χ2=4.507,P<0.05)。结论对于确诊为高血压脑出血且需要采取手术治疗的患者,内镜术的治疗效果明显优于小骨术,且前者能减少术中出血量,缩短手术时间和住院时间,改善神经功能和意识状态,减少并发症的发生。Objective To investigate the clinical efficacy and safety of small bone window craniotomy(hereinafter referred to as"small bone surgery")and neuroendoscopic brain hematoma removal(hereinafter referred to as"endoscopy")in patients with hypertensive cerebral hemorrhage.Methods A total of 80 patients with hypertensive cerebral hemorrhage admitted to Gansu Provincial Hospital of Traditional Chinese Medicine from May 2019 to May 2023 were randomly selected as the research objects.According to different surgical methods,the observation objects were divided into two groups,with 40 cases in each group.The control group was treated with small bone surgery,and the observation group was treated with endoscopy.The therapeutic effect,degree of neurological deficit,recovery of neurological function,state of consciousness and complications were compared between the two groups.Results The intraoperative blood loss in the observation group was less than that in the control group,and the operation time and hospitalization time were shorter than those in the control group,the differences were statistically significant(all P<0.05).At discharge,the National Institutes of Health Stroke Scale score and Modified Rankin Scale score of the observation group were lower than those of the control group,and the Glasgow Coma Score was higher than that of the control group,the differences were statistically significant(all P<0.05).The incidence of complications in the observation group was 2.50%(1/40),which was lower than 20.00%(8/40)in the control group,and the difference was statistically significant(χ2=4.507,P<0.05).Conclusion For patients diagnosed with hypertensive cerebral hemorrhage and requiring surgical treatment,the therapeutic effect of endoscopy is significantly better than that of small bone surgery,and the former can reduce intraoperative blood loss,shorten operation time and hospitalization time,improve neurological function and consciousness,and reduce complications.

关 键 词：高血压脑出血 神经内镜下脑血肿清除术 小骨窗开颅清除术 安全性 

分 类 号：R651.1[医药卫生—外科学]