传统骨瓣开颅和神经内镜治疗基底节脑出血的疗效对比  

Comparison of the Efficacy of Traditional Craniotomy and Neuroendoscopy in the Treatment of Basal Ganglia Hemorrhage

作　　者：史霄汉 SHI Xiaohan(Department of Neurosurgery,Anyang People's Hospital,Anyang Henan 455000,China)

机构地区：[1]安阳市人民医院神经外科,河南安阳455000

出　　处：《临床研究》2025年第1期18-21,共4页Clinical Research

摘　　要：目的传统颅骨瓣手术与神经内窥镜技术在基底节区脑出血治疗中的临床效果比较。方法选取2022年6月至2024年6月间在安阳市人民医院神经外科接受脑出血清除术的131例基底节高血压性脑出血患者的病历资料进行回顾性研究。依据患者所接受的手术类型差异,本研究将患者划分对照组与观察组,对照组共有61名患者,该组患者接受常规开颅手术;观察组共有70名患者,该组患者接受神经内镜手术。本研究对比分析两组患者在手术过程中的多项指标,如手术时间、切口长度、骨窗大小、手术出血量、血块清除效率。同时评价两组患者在入院时、术后第7 d以及出院时的意识状态[采用格拉斯哥昏迷量表(GCS)进行评分],以及术后三个月的生活自理能力[采用Barthel指数进行评分]。结果观察组手术时间、切口长度、骨窗大小以及手术出血量均显著少于对照组,血肿清除效率显著高于对照组,差异具有统计学意义(P<0.05)。入院时,两组GCS评分比较,差异无统计学意义(P>0.05)。在术后7 d以及出院时,观察组GCS评分高于对照组,差异均有统计学意义(P<0.05)。在术后3个月,观察组Barthel指数明显高于对照组,差异具有统计学意义(P<0.05)。结论采用神经内镜辅助的血肿清除手术治疗基底节区高血压性脑出血患者的手术相关指标、短期疗效以及患者康复预后情况均优于传统的开颅血肿清除手术,值得临床应用。Objective To compare the clinical effects of traditional craniotomy and neuroendoscopic techniques in the treatment of basal ganglia hemorrhage.Methods A retrospective study was conducted on the medical records of 131 hypertensive patients with basal ganglia hemorrhage who underwent hematoma evacuation at Anyang People's Hospital's neurosurgery department from June 2022 to June 2024.Based on the type of surgery received,the patients were divided into a control group(61 patients receiving conventional craniotomy)and an observation group(70 patients receiving neuroendoscopic surgery).The study compared various intraoperative indicators,including operation time,incision length,bone window size,intraoperative blood loss,and hematoma clearance efficiency.Additionally,the consciousness state of patients was evaluated using the Glasgow Coma Scale(GCS)at admission,postoperative day 7,and discharge,as well as their ability to perform daily activities assessed by the Barthel Index at three months postoperative.Results The observation group had significantly shorter operation times,smaller incision lengths,smaller bone windows,and reduced intraoperative blood loss compared to the control group.The hematoma clearance efficiency in the observation group was significantly higher than that of the control group(P<0.05).At admission,there was no statistically significant difference in GCS scores between the two groups(P>0.05).However,on postoperative day 7 and at discharge,GCS scores in the observation group were significantly higher than those in the control group(P<0.05).At three months postoperative,the Barthel Index in the observation group was significantly higher than that in the control group(P<0.05).Conclusion The use of neuroendoscopic-assisted hematoma evacuation in treating hypertensive basal ganglia hemorrhage is associated with better surgical-related indicators,short-term efficacy,and rehabilitation outcomes compared to traditional craniotomy.This technique is recommended for clinical practice.

关 键 词：开颅 神经内镜 基底节脑出血 昏迷 血肿 

分 类 号：R743.34[医药卫生—神经病学与精神病学]