神经内镜下血肿清除术与小骨窗开颅血肿清除术对幕上高血压脑出血患者神经功能及并发症的影响  

Effect of Removal of Hematoma Under Neuroendoscope and Craniotomy with Small Bone Window on Neurological Function and Complications in Patients with Supratentorial Hypertensive Intracerebral Hemorrhage

作　　者：孔祥铨 毛恩霞 KONG Xiangquan;MAO Enxia(Department of Neurosurgery,Linyi Central Hospital,Linyi 276400,China;Department of Rehabilitation Medicine,Linyi Central Hospital,Linyi 276400,China)

机构地区：[1]临沂市中心医院神经外科,山东临沂276400 [2]临沂市中心医院康复医学科,山东临沂276400

出　　处：《反射疗法与康复医学》2024年第19期113-116,共4页Reflexology And Rehabilitation Medicine

摘　　要：目的 探讨神经内镜下血肿清除术与小骨窗开颅血肿清除术对幕上高血压脑出血(HICH)患者的治疗效果。方法 选取2021年10月—2023年10月临沂市中心医院收治的102例幕上HICH患者为研究对象,按随机数字表法将其分为对照组和观察组,各51例。对照组行小骨窗开颅血肿清除术,观察组行神经内镜下血肿清除术。对比两组患者的手术相关指标、神经功能、日常生活能力、生活质量及并发症发生情况。结果 观察组术中出血量为(87.53±6.95)mL,少于对照组的(168.95±14.53)mL,手术时间为(65.24±7.25)min,住院时间为(14.42±2.31)d,均短于对照组的(107.21±10.54)min、(20.53±2.97)d,血肿清除率为94.12%,高于对照组的80.39%,并发症发生率为3.92%,低于对照组的17.65%,组间差异有统计学意义(P<0.05)。术后1个月,观察组美国国立卫生研究院卒中量表评分为(11.57±1.56)分,低于对照组的(15.31±2.15)分,日常生活能力量表评分为(79.84±5.21)分,高于对照组的(70.58±4.39)分,组间差异有统计学意义(P<0.05);观察组生活质量综合评定问卷中的躯体功能、心理功能、社会功能、物质生活状态评分分别为(78.53±4.98)分、(78.96±4.56)分、(80.53±4.16)分、(81.96±5.30)分,均高于对照组的(69.75±4.20)分、(71.34±3.97)分、(72.46±3.42)分、(73.59±4.11)分,组间差异有统计学意义(P<0.05)。结论 神经内镜下血肿清除术存在创伤小、恢复快等优势,更能够减轻幕上HICH患者的神经损伤,提高其日常生活能力、生活质量,且并发症少。Objective To investigate the effect of removal of hematoma under neuroendoscope and craniotomy with small bone window on supratentorial hypertensive intracerebral hemorrhage(HICH).Methods A total of 102 patients with supratentorial HICH treated in Linyi Central Hospital from October 2021 to October 2023 were selected as the research objects,and were divided into a control group and an observation group according to random number table method,with 51 cases in each group.The control group underwent small bone window craniotomy hematoma removal,and the observation group underwent neuroendoscopic hematoma removal.The surgical indicators,neurological function,ability of daily living,quality of life and occurrence of complications were compared between the two groups.Results The intraoperative blood loss in the observation group was(87.53±6.95)mL,which was less than(168.95±14.53)mL in the control group,the operative time was(65.24±7.25)min,and the length of hospitalization was(14.42±2.31)d,which were shorter than(107.21±10.54)min and(20.53±2.97)d of the control group,the clearance rate of hematoma was 94.12%,which was higher than 80.39% of the control group,the complication rate was 3.92%,which was lower than 17.65% of the control group,the differences between the groups were statistically significant(P<0.05).One month after surgery,the score of the National Institutes of Health Stroke Scale in the observation group was(11.57±1.56) points,which was lower than(15.31±2.15) points in the control group,and the score of the Activities of Daily Living Scale was(79.84±5.21) points,which was higher than(70.58±4.39) points in the control group,the differences between the groups were statistical significance(P<0.05);the scores of physical function,psychological function,social function and material life status in the Generic Quality of Life Inventory of the observation group were(78.53 ±4.98)points,(78.96±4.56) points,(80.53±4.16) points and(81.96±5.30) points,respectively,which were higher than(69.75 ±4.20)points

关 键 词：幕上高血压脑出血 小骨窗开颅血肿清除术 生活质量 并发症 

分 类 号：R743.2[医药卫生—神经病学与精神病学]