幕上脑出血内镜手术与保守治疗、锥颅引流治疗的临床对比研究  

A clinical comparative study of endoscopic surgery,craniopuncture and conservative treatment for supratentorial intracerebral hemorrhage

作　　者：李鹏[1] 姚志刚[1] 张建辉[1] 孙志敏[1] 高明明[1] 郝亮[1] Li Peng;Yao Zhigang;Zhang Jianhui;Sun Zhimin;Gao Mingming;Hao Liang(Department of Neurosurgery,the Shjiazhuang Third Hospital,Hebei 050011,China)

机构地区：[1]石家庄市第三医院神经外科,河北050011

出　　处：《脑与神经疾病杂志》2025年第4期245-248,共4页Journal of Brain and Nervous Diseases

基　　金：石家庄市科学技术研究与发展计划(171461633)。

摘　　要：目的研究神经内镜下血肿清除术、锥颅引流术、保守治疗在治疗幕上脑出血的有效性及预后。方法研究对象选取2019年7月至2023年9月在石家庄市第三医院神经外科治疗的132例幕上脑出血患者,其中49例接受内镜血肿清除术,此为内镜组;38例接受锥颅引流术,归入穿刺组;45例选择保守治疗,归入保守组。观察指标包括脑水肿、并发症发生率、GOS评分、Barthel指数等。结果术后脑梗死、肺部感染、肾功能以及脑水肿等指标,内镜组好于保守组;3组患者组间90d,GOS评分比较、ADL量表(Barthel指数)比较,预后差异无统计学意义(P<0.05)。结论微创手术治疗幕上脑出血,虽然长期预后无明显改善,但是改善患者脑水肿的同时,可以降低患者术后并发症的发生率,是可行的和有效的治疗方案。Objective To evaluate the effects of minimally invasive craniopuncture therapy and neuroendoscopic therapy compared with conservative treatment in treating spontaneous intracerebral hemorrhage.Methods Analysis 132 cases of spontaneous intracerebral hemorrhage patients.Among them,49 cases were treated with endoscopic,38 cases were treated with craniopuncture,and 45 cases were treated conservatively.The outcome measures included cerebral edema,complication rate,the Glasgow outcome scale(GOS)and Barthel Index(BI).Results Cerebral infarction,pulmonary infection,renal function and brain edema,these indexes in endoscopic group were better than those in conservative group.There was no significant difference in GOS and BI between the three groups.Conclusion Minimally invasive surgery for supratentorial intracerebral hemorrhage,although the long-term prognosis is not significantly improved,but improve the brain edema of patients,reduce the incidence of complications during hospitalization,neuroendoscopic therapy is a viable and effective treatment option.

关 键 词：脑出血 神经内镜 锥颅引流术 

分 类 号：R743.34[医药卫生—神经病学与精神病学]