神经内镜下经额锁孔入路与显微镜下经颞锁孔入路手术治疗基底节区脑出血的效果评价  

Evaluation of the Effect of Neuroendoscopic Transfrontal Keyhole Approach and Microscopic Transtemporal Keyhole Approach in the Treatment of Cerebral Hemorrhage in Basal Ganglia

作　　者：李仁涛 张继鑫 LI Rentao;ZHANG Jixin(Department of Neurosurgery,Jinan Jiyang District People's Hospital,Jinan 251400,Shandong,China)

机构地区：[1]济南市济阳区人民医院神经外科,山东济南251400

出　　处：《系统医学》2025年第3期111-114,共4页Systems Medicine

摘　　要：目的对比神经内镜下经额锁孔入路、显微镜下经颞锁孔入路在基底节区脑出血临床治疗中的应用效果。方法非随机选取2019年7月—2023年12月济南市济阳区人民医院收治的80例基底节区脑出血患者为研究对象,按手术方式不同分为两组,各40例。对照组采用显微镜下经颞锁孔入路手术治疗,观察组采用神经内镜下经额锁孔入路手术治疗。对比两组手术指标、神经功能、并发症发生情况。结果观察组手术时间为(95.12±2.42)min、术中出血量为(99.32±2.81)mL,优于对照组的(122.31±2.81)min、(112.32±2.88)mL,差异有统计学意义(t=46.371、20.434,P均<0.05)。观察组血肿清除率为(90.12±2.56)%、住院时间为(14.82±2.15)d,对照组为(90.18±2.45)%、(14.88±2.11)d,两组对比,差异无统计学意义(t=0.107、0.126,P均>0.05)。术前两组患者美国国立卫生研究院卒中量表评分对比,差异无统计学意义(P>0.05)。术后两组评分均下降,且观察组比对照组低,差异有统计学意义(P<0.05)。两组并发症发生率对比,差异无统计学意义(P>0.05)。结论基底节区脑出血行神经内镜下经额锁孔入路手术或显微镜下经颞锁孔入路手术,在血肿清除效果、安全性方面均呈持平之势,但前者手术操作时间更短,出血少,神经功能改善效果更为显著。Objective To compare the application effect of neuroendoscopic frontal keyhole approach and microscopic temporal keyhole approach in the clinical treatment of cerebral hemorrhage in basal ganglia.Methods A total of eighty patients with cerebral hemorrhage in basal ganglia admitted to Jinan Jiyang District People's Hospital from July 2019 to December 2023 were non-randomly selected as the research objects and divided into two groups according to different surgical methods,with forty cases in each group.The control group was treated by temporal keyhole approach under microscope,and the observation group was treated by frontal keyhole approach under neuroendoscope.The surgical indicators,neurological function and complications were compared between the two groups.Results The operation time of the observation group was(95.12±2.42)min,the intraoperative blood loss was(99.32±2.81)mL,which was better than(122.31±2.81)min,(112.32±2.88)mL of the control group,the differences were statistically significant(t=46.371,20.434,both P<0.05).The hematoma clearance rate of the observation group was(90.12±2.56)%,the hospitalization time was(14.82±2.15)d,and the control group was(90.18±2.45)%,(14.88±2.11)d.There was no statistical significant difference between the two groups(t=0.107,0.126,both P>0.05).There was no statistical significant difference in The National Institutes of Health Stroke Scale score between the two groups before operation(P>0.05).The scores of the two groups decreased after operation,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Neuroendoscopic transfrontal keyhole approach or microscopic transtemporal keyhole approach for cerebral hemorrhage in basal ganglia showed a flat trend in hematoma removal effect and safety,but the former had shorter operation time,less bleeding and more significant improvement of neurological function.

关 键 词：神经内镜 经额锁孔入路 显微镜 经颞锁孔入路 基底节区脑出血 

分 类 号：R651.1[医药卫生—外科学]