经额部与经颞部入路微创钻孔引流术治疗高血压脑出血患者的效果比较  

Comparison of effects of minimally invasive trepanation and drainage through frontal and temporal approaches in treatment of patients with hypertensive cerebral hemorrhage

作　　者：麻洪波 MA Hongbo(Department of Neurosurgery of Pingyu County Central Hospital,Zhumadian 463400 Henan,China)

机构地区：[1]平舆县中心医院神经外科,河南驻马店463400

出　　处：《中国民康医学》2025年第5期132-135,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较经额部与经颞部入路微创钻孔引流术治疗高血压脑出血(HICH)患者的效果。方法:回顾性分析2021年7月至2023年7月该院收治的89例HICH患者的临床资料,根据手术方案不同将其分为对照组(n=44)与研究组(n=45)。对照组行经颞部入路微创钻孔引流术治疗,研究组行经额部入路微创钻孔引流术治疗。比较两组围手术期指标(意识障碍恢复时间、住院时间、手术时间、手术时间以及术后3、7 d血肿残余量,手术前后神经功能缺损程度[美国国立卫生研究院卒中量表(NIHSS)]评分、血管内皮功能指标[血管生成素-1(Ang-1),血管内皮素(ET)、一氧化氮(NO)]水平、颅内压水平、认知功能[简易智力状态检查量表(MMSE)]评分、日常生活能力[改良Barthel指数(MBI)]评分,以及并发症发生率。结果:两组手术时间比较,差异无统计学意义(P>0.05);研究组意识障碍恢复时间、住院时间均短于对照组,术后3、7 d血肿残余量均少于对照组,差异有统计学意义(P<0.05);术后7 d、1个月、3个月,两组NIHSS评分均低于术前,且研究组低于对照组,差异有统计学意义(P<0.05);术后7 d,两组ET、Ang-1、颅内压水平均低于术前,且研究组低于对照组,两组NO水平均高于术前,且研究组高于对照组,差异有统计学意义(P<0.05);术后1、3个月,两组MMSE、MBI评分均高于术前,且研究组高于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:经额部入路微创钻孔引流术治疗HICH患者可提高MMSE、MBI评分,缩短意识障碍恢复时间和住院时间,减少血肿残余量,改善血管内皮功能指标水平,以及降低NIHSS评分和颅内压水平,效果优于经颞部入路微创钻孔引流术治疗。Objective:To compare effects of minimally invasive trepanation and drainage through frontal and temporal approaches in treatment of patients with hypertensive intracerebral hemorrhage(HICH).Methods:The clinical data of 89 patients with HICH admitted to this hospital from July 2021 to July 2023 were retrospectively analyzed.According to the different surgical procedures,they were divided into control group(n=44) and study group(n=45).The control group was treated with minimally invasive trepanation and drainage through temporal approach,while the study group was treated with minimally invasive trepanation and drainage through frontal approach.The perioperative indexes(recovery time of consciousness disorder,hospitalization time,operation time,hematoma residual volume 3 days after the surgery,hematoma residual volume 7days after the surgery),the degree of neurological impairment before and after the surgery [National Institutes of Health stroke scale(NIHSS)] score,the vascular endothelial function indexes [angiopoietin-1(Ang-1),vascular endothelin(ET),nitric oxide(NO)] levels,the intracranial pressure level,the cognitive function [mini-mental state examination(MMSE)] score,the daily living ability [modified Barthel index(MBI)] score,and the incidence of complications were compared between the two groups.Results:There was no significant difference in the operation time between the two groups(P>0.05).The recovery time of consciousness disorder and the hospitalization time in the study group were shorter than those in the control group,the residual volume levels of hematoma 3 and 7 days after the surgery were less than those in the control group,and the differences were statistically significant(P<0.05).At 7 days,1 month and 3 months after the surgery,the NIHSS scores of the two groups were lower than those before the surgery,those of the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).At 7 days after the surgery,the levels of ET,Ang-1 and intracranial

关 键 词：经颞部入路 经额部入路 微创钻孔引流术 高血压脑出血 

分 类 号：R651.12[医药卫生—外科学]