脑膜中动脉截断术和神经内镜联合治疗慢性硬膜下血肿对患者血肿完全吸收率、复发率的影响  

Effect of Middle Meningeal Artery Amputation Combined with Neuroendoscopy on Complete Absorption Rate and Recurrence Rate of Chronic Subdural Hematoma

作　　者：覃学良 QIN Xueliang(Department of Neurosurgery,Sinan County People's Hospital,Tongren,Guizhou,565100,China)

机构地区：[1]思南县人民医院神经外科,贵州铜仁565100

出　　处：《中外医疗》2024年第36期54-57,共4页China & Foreign Medical Treatment

摘　　要：目的探讨脑膜中动脉截断术和神经内镜联合治疗慢性硬膜下血肿(chronic subdural hematoma,CSDH)对患者血肿完全吸收率、复发率的影响。方法随机选取2022年3月—2024年4月思南县人民医院收治的80例CSDH患者为研究对象,按照不同手术方法分为两组,对照组40例患者手术为神经内镜辅助下清除血肿,观察组40例患者手术为神经内镜辅助清除并脑膜中动脉截断术。比较两组手术相关指标、血肿清除率、术后复发率、神经功能。结果两组手术时间、术中出血量、住院时间比较,差异均无统计学意义(P均>0.05)。术后48 h内复查头颅CT显示,观察组40例血肿清除彻底、完全消失,对照组40例血肿清除彻底、完全消失,两组清除率一致。术后随访3~6个月,观察组复发率0%(0/40)低于对照组的15.00%(6/40),差异有统计学意义(χ^(2)=4.505,P=0.034)。治疗后,观察组美国国立卫生研究所的卒中量表评分低于对照组,差异有统计学意义(P<0.05)。结论脑膜中动脉截断术和神经内镜联合治疗CSDH相较于单纯神经内镜手术,能显著降低CSDH复发率,促进神经功能恢复。Objective To investigate the effects of middle meningeal artery amputation and neuroendoscopy in the treatment of chronic subdural hematoma(CSDH)on the complete absorption rate and recurrence rate of patients with hematoma.Methods A total of 80 patients with CSDH admitted to Sinan County People's Hospital from March 2022 to April 2024 were randomly selected as the research objects and divided into two groups according to different surgical methods.40 patients in the control group were treated with neuroendoscopy-assisted hematoma removal,and 40 patients in the observation group were treated with neuroendoscopy-assisted hematoma removal and middle meningeal artery amputation.The operation related indexes,hematoma clearance rate,postoperative recurrence rate and neurological function were compared between the two groups.Results There were no significant differences in operation time,intraoperative blood loss and hospitalization time between the two groups(all P>0.05).Head CT reexamination within 48 h after operation showed that 40 cases of hematoma in the observation group were completely removed and completely disappeared,and 40 cases of hematoma in the control group were completely removed and completely disappeared.The clearance rate of the two groups was consistent.After 3-6 months of follow-up,the recurrence rate of the observation group was 0%(0/40)lower than that of the control group 15.00%(6/40),the difference was statistically significant(χ^(2)=4.505,P=0.034).After treatment,the National Institutes of Health Stroke Scale score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion The combination of middle meningeal artery amputation and neuroendoscopy in the treatment of CSDH can significantly reduce the recurrence rate of CSDH and promote the recovery of nerve function compared with neuroendoscopic surgery alone.

关 键 词：慢性硬膜下血肿 脑膜中动脉截断术 神经内镜 手术 吸收率 复发率 

分 类 号：R605[医药卫生—外科学]