显微镜下开颅血肿清除术与神经内镜辅助下血肿清除术治疗小脑出血的效果对比  

Comparison on the Effects of Microscopic Craniotomy Hematoma Removal and Neuroendoscopy-Assisted Hematoma Removal in the Treatment of Cerebellar Hemorrhage

作　　者：陈涛 贾婷君 CHEN Tao;JIA Tingjun(Department of Neurosurgery,Zhengzhou Ninth People's Hospital,Zhengzhou 450053,China)

机构地区：[1]郑州市第九人民医院神经外科,河南郑州450053

出　　处：《临床医学工程》2025年第3期303-307,共5页Clinical Medicine & Engineering

摘　　要：目的 对比分析显微镜下开颅血肿清除术与神经内镜辅助下血肿清除术治疗小脑出血患者的临床效果。方法 选取我院2022年10月至2024年5月收治的120例小脑出血患者作为研究对象,根据手术治疗方式的不同分为显微镜组(n=58)和神经内镜组(n=62)。显微镜组给予显微镜下开颅血肿清除术治疗,神经内镜组给予神经内镜辅助下血肿清除术治疗。比较两组的手术相关指标、血肿量、血肿清除率、免疫功能指标、术后并发症以及预后。结果 神经内镜组的术中出血量少于显微镜组,切口长度、骨窗面积均小于显微镜组,手术时间及住院时间均短于显微镜组(P <0.05)。术后7 d,两组的血肿量均较术前降低(P<0.05);且神经内镜组术后7 d的血肿量低于显微镜组,血肿清除率高于显微镜组(P <0.05)。两组术后7 d的血清Ig A、 Ig G、Ig M水平均较术前降低,但神经内镜组的血清Ig A、 Ig G、 Ig M水平均高于显微镜组(P <0.05)。神经内镜组的术后并发症发生率为4.84%,低于显微镜组的18.97%(P <0.05)。两组的预后GOS评分对比,差异无统计学意义(P>0.05)。结论 相较于显微镜下开颅血肿清除术,神经内镜辅助下血肿清除术可显著提高小脑出血患者的血肿清除率,优化手术及康复质量,降低对患者免疫指标的不良影响及并发症发生风险。Objective To compare and analyze the clinical effects of microscopic craniotomy hematoma removal and neuroendoscopy-assisted hematoma removal in the treatment of patients with cerebellar hemorrhage.Methods A total of 120 patients with cerebellar hemorrhage admitted to our hospital from October 2022 to May 2024 were selected as the research subjects.Based on the different surgical treatment methods,all cases were divided into the microscope group(n=58)and the neuroendoscopy group(n=62).The microscope group was treated with microscopic craniotomy hematoma removal,while the neuroendoscopy group was treated with neuroendoscopy-assisted hematoma removal.The surgical-related indicators,hematoma volume,hematoma clearance rate,immune function indicators,postoperative complications,and prognosis were compared between the two groups.Results The intraoperative blood loss of the neuroendoscopy group was less than that of the microscope group,the incision length and bone window area were smaller than those of the microscope group,and the operation time and hospitalization time were shorter than those of the microscope group(P<0.05).At 7 d after surgery,the hematoma volumes in both groups were lower than those before surgery(P<0.05);The hematoma volume at 7 d after surgery in the neuroendoscopy group was lower than that in the microscope group,and the hematoma clearance rate was higher than that in the microscope group(P<0.05).At 7 d after surgery,the levels of serum IgA,IgG,and IgM in both groups were lower than those before surgery,while the levels of serum IgA,IgG,and IgM in the neuroendoscopy group were higher than those in the microscope group (P <0.05). The incidence of postoperative complications in the neuroendoscopy group was 4.84%, lower than the 18.97% in themicroscope group (P <0.05);No statistically significant difference was found in the prognosis GOS score between the two groups (P >0.05).Conclusions Compared with microscopic craniotomy hematoma removal, neuroendoscopy-assisted hematoma removal can significantly

关 键 词：小脑出血 显微镜下开颅血肿清除术 神经内镜辅助下血肿清除术 免疫功能 并发症 预后 

分 类 号：R651.1[医药卫生—外科学]