两种不同手术方式治疗高血压性基底节区出血破入脑室的临床效果比较  

Comparison of clinical effects of two different surgical methods in the treatment of hypertensive basal ganglia hemorrhage breaking into ventricles

作　　者：范文斌 杜成华[1] FAN Wenbin;DU Chenghua(Affiliated Hospital of Inner Mongolia Minzu University,Tongliao 028007,China)

机构地区：[1]内蒙古民族大学附属医院,内蒙古通辽028007

出　　处：《临床医学研究与实践》2025年第8期58-61,共4页Clinical Research and Practice

基　　金：2023年度内蒙古自治区直属高校基本科研项目——在校优秀学生基本科研能力提升计划(No.GXKY23Z073)。

摘　　要：目的比较两种不同手术方式治疗高血压性基底节区出血破入脑室的临床效果。方法选择75例高血压性基底节区出血破入脑室患者为研究对象,根据不同的手术方法将其分为内镜组(37例,神经内镜辅助下血肿清除置管引流术)与穿刺组(38例,血肿腔穿刺引流术联合脑室外引流术)。比较两组的手术效果。结果内镜组的住院天数短于穿刺组,住院花费、术后第1天血肿清除率高于穿刺组,手术时间长于穿刺组,术后第1天残余血量少于穿刺组(P<0.001)。内镜组的脑积水、颅内感染发生率低于穿刺组(P<0.05)。术后不同时间,内镜组的日常生活能力(ADL)、改良Rankin量表(MRS)、美国国立卫生研究院卒中量表(NIHSS)、格拉斯哥昏迷量表(GCS)、格拉斯哥预后量表(GOS)评分优于穿刺组(P<0.05)。结论神经内镜辅助下血肿清除置管引流术治疗高血压性基底节区出血破入脑室患者的临床效果较为理想,可获得更高的血肿清除率。Objective To compare the clinical effects of two different surgical methods in the treatment of hypertensive basal ganglia hemorrhage breaking into ventricle.Methods A total of 75 patients with hypertensive basal ganglia hemorrhage breaking into ventricles were selected as the research objects.According to different surgical methods,the patients were divided into endoscopy group(37 cases,neuroendoscopy-assisted hematoma removal and catheter drainage)and puncture group(38 cases,hematoma cavity puncture drainage combined with external ventricular drainage).The surgical effects of the two groups were compared.Results The length of hospital stay in the endoscopic group was shorter than that in the puncture group,the hospitalization cost and the hematoma clearance rate on the first day after operation were higher than those in the puncture group,the operation time was longer than that in the puncture group,and the residual blood volume on the first day after operation was less than that in the puncture group(P<0.001).The incidence of hydrocephalus and intracranial infection in the endoscopic group were lower than those in the puncture group(P<0.05).At different time after operation,the scores of Activies Daily Living(ADL),Modified Rankin Scale(MRS),National Institutes of Health Stroke Scale(NIHSS),Glasgow Coma Scale(GCS)and Glasgow Outcome Scale(GOS)in the endoscopic group were better than those in the puncture group(P<0.05).Conclusion The neuroendoscopy-assisted hematoma removal and catheter drainage in the treatment of patients with hypertensive basal ganglia hemorrhage breaking into ventricle has ideal clinical effect,which can obtain a higher hematoma clearance rate.

关 键 词：神经内镜 血肿清除置管引流术 血肿腔穿刺引流术 脑室外引流术 高血压性基底节区出血破入脑室 

分 类 号：R615[医药卫生—外科学]