神经内镜微创手术与微创钻孔引流术治疗高血压脑出血的效果比较  

Comparison on the Effects of Neuroendoscopic Minimally Invasive Surgery Versus Burr Hole Irrigation and Drainage in the Treatment of Hypertensive Intracerebral Hemorrhage

作　　者：汪仲伟 吴环立[1] 郭京立 王晓斌 WANG Zhongwei;WU Huanli;GUO Jingli;WANG Xiaobin(Department of Neurosurgery,Nanyang Second People's Hospital,Nanyang 473000,China;Department of Neurosurgery,the First Affiliated Hospital of He'nan University,Kaifeng 475001,China)

机构地区：[1]南阳市第二人民医院神经外科,河南南阳473000 [2]河南大学第一附属医院神经外科,河南开封475001

出　　处：《临床医学工程》2025年第1期61-64,共4页Clinical Medicine & Engineering

基　　金：河南省医学科技攻关计划联合共建项目(项目编号:LHGJ20190508)。

摘　　要：目的对比神经内镜微创手术与微创钻孔引流术(BHID)治疗高血压脑出血(HICH)的临床效果。方法选取2022年2月至2024年7月南阳市第二人民医院收治的90例HICH患者,随机分为两组各45例。A组行神经内镜微创手术治疗,B组行BHID治疗。比较两组的手术相关指标、炎性反应、日常生活能力、神经功能、预后情况及并发症。结果A组的手术时间显著长于B组,术中出血量、术后48h血肿清除率均显著高于B组(P<0.05)。术后14d,A组的血清hs-CRP、TNF-α、IL-6水平均显著低于B组(P<0.05)。术后3个月,A组的MBI评分显著高于B组,NIHSS评分显著低于B组(P<0.05)。A组的预后不良率、并发症总发生率均显著低于B组(P<0.05)。结论与BHID相比,神经内镜微创手术治疗HICH的效果更好,能更显著地提高血肿清除率,减轻患者的炎性反应,改善患者的神经功能及预后,提高患者的日常生活能力,减少并发症的发生。Objective To compare the clinical effects of neuroendoscopic minimally invasive surgery versus burr hole irrigation and drainage(BHID)in the treatment of hypertensive intracerebral hemorrhage(HICH).Methods 90 HICH patients admitted to Nanyang Second People's Hospital from February 2022 to July 2024 were selected and randomly divided into two groups,with 45 cases in each group.Group A was treated with neuroendoscopic minimally invasive surgery,while group B was treated with BHID.The surgical related indicators,inflammatory response,daily living ability,neurological function,prognosis,and complications were compared between the two groups.Results The operation time of group A was significantly longer than that of group B,and the intraoperative blood loss amount and hematoma clearance rate within 48 hours after surgery were significantly higher than those of group B(P<0.05).At 14 days after surgery,the levels of serum hs-CRP,TNF-αand IL-6 of group A were significantly lower than those of group B(P<0.05).At 3 months after surgery,the MBI score of group A was significantly higher than that of group B,and the NIHSS score was significantly lower than that of group B(P<0.05).The poor prognosis rate and total incidence of complications of group A were significantly lower than those of group B(P<0.05).Conclusions Compared with BHID,neuroendoscopic minimally invasive surgery has better effect in the treatment of HICH,which can more significa ntly improve hematoma clearance rate,alleviate patients'inflammatory response,improve patiensts'neurological functionand prognosis,enhance patientsd'aily living ability,and reduce the occurrenceofcomplications.

关 键 词：高血压脑出血 神经内镜微创手术 微创钻孔引流术 神经功能 炎性反应 日常生活能力 并发症 

分 类 号：R743.2[医药卫生—神经病学与精神病学]