神经内镜控制下血肿清除术与开颅血肿清除术治疗自发性小脑出血患者临床疗效比较  

A comparison of the clinical efficacy between neuroendoscopic assisted controlled hematoma evacuation and craniotomy hematoma evacuation for the treatment of spontaneous cerebellar hemorrhage patients

作　　者：赵顺忠 杨阳 鲁华山 司玥 张明浩 段权博 李立宏 ZHAO Shunzhong;YANG Yang;LU Huashan;SI Yue;ZHANG Minghao;DUAN Quanbo;LI Lihong(Emergency Department of the 73rd Group Army Hospital of the Army,Xiamen,Fujian 361000,China;Department of Emergency the Second Affiliated Hospital of Air Force Military Medical University,Xi'an,Shaanxi 710038,China;Department of Internal Medicine,the 63710 Military Hospital of the Chinese Peoples Liberation Army,Xinzhou,Shanxi 036301,China;Rocket Army Guangzhou Special service Recuperation Centre,Guangzhou,Guangdong 510515,China;Emergency Department of Xi'an High tech Hospital,Xi'an,Shaanxi 710065,China)

机构地区：[1]陆军第七十三集团军医院急诊科,福建厦门361000 [2]空军军医大学第二附属医院急诊科,陕西西安710038 [3]火箭军广州特勤疗养中心,广东广州510515 [4]中国人民解放军63710部队医院内科,山西忻州036301 [5]西安市高新医院急诊科,陕西西安710065

出　　处：《中华神经外科疾病研究杂志》2025年第1期26-31,共6页Chinese Journal of Neurosurgical Disease Research

基　　金：陕西省重点研发计划项目(项目编号:2017ZDXM-SF-042)。

摘　　要：目的比较神经内镜控制下血肿清除术与开颅血肿清除术治疗自发性小脑出血患者的临床疗效,探讨神经内镜治疗的临床意义。方法回顾分析2012年1月至2019年9月空军军医大学第二附属医院收治的自发性小脑出血患者的病例资料,根据手术方式不同将患者分为研究组和对照组。对照组采用开颅血肿清除术治疗,研究组采用神经内镜控制下血肿清除术治疗。比较两组患者围手术期指标及出院后12个月功能预后。结果研究组28例,对照组34例,患者平均年龄分别为(62.32±10.85)岁和(59.68±11.40)岁。研究组和对照组患者基线资料、实验室指标、影像学资料比较差异无统计学意义(P>0.05)。研究组血肿清除率明显高于对照组(P<0.05),手术用时、术中出血量、出院后12个月不良预后率明显低于对照组(P<0.05)。结论神经内镜控制下血肿清除术治疗自发性小脑出血患者,手术用时短,术中出血量少,血肿清除率高,可改善患者远期功能及预后。Objective To compare the clinical efficacy of neuroendoscopic controlled hematoma evacuation and craniotomy hematoma evacuation for the treatment of patients with spontaneous cerebellar hemorrhage,and to explore the clinical significance of neuroendoscopic treatment.Methods The data of patients with spontaneous cerebellar hemorrhage admitted to the Second Affiliated Hospital of the Air Force Medical University from January 2012 to September 2019 were retrospectively analyzed,and the patients were divided into study group and control group according to different surgical methods.The control group was treated with craniotomy hematoma evacuation,and the study group was treated with neuroendoscopic controlled hematoma evacuation.The perioperative indexes and functional prognosis at 12 months after discharge were compared between the two groups.Results There were 28 cases in the study group and 34 cases in the control group,with an average age of 62.32±10.85 years and 59.68±11.40 years,respectively.There was no significant difference in baseline data,laboratory indexes and imaging data between the two groups(P>0.05).The rate of hematoma clearance in the study group was significantly higher than that in the control group(P<0.05).The operation time,intraoperative blood loss,adverse prognosis rate at 12 months after discharge in the study group were significantly lower than those in the control group(P<0.05).Conclusions Neuroendoscopic controlled hematoma evacuation for the treatment of patients with spontaneous cerebellar hemorrhage takes a short time,has less intraoperative blood loss,and has a high hematoma clearance rate,which can improve the long-term function and prognosis of patients.

关 键 词：自发性小脑出血 血肿清除术 神经内镜 开颅 改良Rankin量表 格拉斯哥昏迷量表 

分 类 号：R651.1[医药卫生—外科学]