神经内镜微创手术治疗高血压脑出血的近期疗效及远期预后观察  

Observation of short-term efficacy and long-term prognosis of neuroendoscopic minimally invasive surgery for hypertensive cerebral hemorrhage

作　　者：冉光辉 汪双 陈江建 刘旭 RAN Guanghui;WANG Shuang;CHEN Jiangjian;LIU Xu(Department of Neurosurgery,Guizhou Provincial Staff Hospital,Guiyang,Guizhou 550025,China)

机构地区：[1]贵州省职工医院神经外科,贵州贵阳550025

出　　处：《医药前沿》2025年第5期32-34,37,共4页Journal of Frontiers of Medicine

摘　　要：目的观察神经内镜微创手术治疗高血压脑出血的近期疗效及远期预后。方法选取2021年9月—2023年3月贵州省职工医院50例高血压脑出血患者,根据不同治疗方法分为观察组(n=27,神经内镜微创手术)和对照组(n=23,小骨窗开颅血肿清除术)。比较两组血肿清除率,术前及术后6个月脑源性神经营养因子(BDNF)水平、格拉斯哥昏迷评分(GCS)、美国国立卫生研究院卒中量表(NIHSS)评分,术后6个月并发症发生率。结果观察组术后血肿清除率高于对照组,差异有统计学意义(P<0.05)。术后6个月,观察组GCS及BDNF水平均高于对照组,NIHSS评分、并发症总发生率均低于对照组,差异有统计学意义(P<0.05)。结论高血压脑出血患者行神经内镜微创手术后近期血肿清除率高,远期神经营养因子水平、意识清醒程度、神经功能恢复程度更高,且并发症风险更低。Objective To observe the short-term efficacy and long-term prognosis of neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage.Methods From September 2021 to March 2023,a total of 50 patients with hypertensive cerebral hemorrhage in Guizhou Provincial Staff Hospital were selected and divided into observation group(n=27,neuroendoscopic minimally invasive surgery)and control group(n=23,small bone window craniotomy hematoma removal)by different therapeutic methods.The hematoma clearance rate,brain derived neuro-trophic factor(BDNF)level,Glasgow Coma Scale(GCS),National Institute of Health Stroke Scale(NIHSS)score before surgery and 6 months after surgery,and the incidence of complications in 6 months after surgery were compared between the two groups.Results The hematoma clearance rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).6 months after surgery,the GCS and BDNF levels in the observation group were higher than those in the control group,while the NIHSS scores and the total incidence of complications were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusions Neuroendoscopic minimally invasive surgery has a high hematoma clearance rate in the short term after surgery in patients with hypertensive cerebral hemorrhage,and has higher levels of neurotrophic factors,a higher degree of consciousness recovery,a higher degree of neurological function recovery,and a lower risk of complications in the long term after surgery.

关 键 词：高血压 脑出血 神经内镜 微创手术 神经功能 并发症 血肿清除 

分 类 号：R743[医药卫生—神经病学与精神病学]