内镜下微创手术治疗高血压脑出血的效果  

Effect of Endoscopic Minimally Invasive Surgery in the Treatment of Hypertensive Cerebral Hemorrhage

作　　者：陶开剑[1] TAO Kaijian(Department of Brain Surgery,Xuyi Hospital of Traditional Chinese Medicine,Huai'an 211700,Jiangsu,China)

机构地区：[1]盱眙县中医院脑外科,江苏淮安211700

出　　处：《世界复合医学(中英文)》2025年第2期112-116,共5页World Journal of Complex Medicine

摘　　要：目的探究内镜下微创手术在高血压脑出血(hypertensive cerebral hemorrhage,HCH)治疗中的应用效果。方法按照手术方式的不同,将2022年1月—2024年10月盱眙县中医院收治的83例HCH患者分为对照组(40例,进行小骨窗开颅术)、研究组(43例,进行内镜下微创术)。比较两组血肿清除率、术后并发症发生率、手术指标、神经功能、炎症因子、预后情况。结果研究组血肿清除率为(91.24±1.02)%,相比于对照组的(82.35±1.01)%更高,差异有统计学意义(t=39.864,P<0.001)。相比于对照组,研究组术后并发症发生率更低,手术时间、住院时间均更短,术中出血量更少,手术切口更小,差异均有统计学意义(P均<0.05)。治疗后,相比于对照组,研究组神经元特异性烯醇化酶、S100β蛋白、白细胞介素-2、白细胞介素-6、肿瘤坏死因子-α水平均更低,脑源性神经营养因子水平、睁眼反应、口头反应、运动反应评分更高,差异均有统计学意义(P均<0.05)。结论内镜下微创手术治疗HCH效果好、并发症发生率低,神经功能恢复良好,可减轻炎症损伤。Objective To explore the application effect of endoscopic minimally invasive surgery in the treatment of hypertensive cerebral hemorrhage(HCH).Methods According to the different surgical methods,a total of 83 HCH patients admitted to Xuyi Hospital of Traditional Chinese Medicine from January 2022 to October 2024 were selected and divided into the control group(40 cases,small bone window craniotomy)and the study group(43 cases,endoscopic minimally invasive surgery).The hematoma clearance rate,incidence of postoperative complication,surgical indicators,neurological function,inflammatory factors and prognosis were compared between the two groups.Results The hematoma clearance rate of the study group was(91.24±1.02)%,which was higher than(82.35±1.01)%compared with the control group,and the difference was statistically significant(t=39.864,P<0.001).Compared with the control group,the incidence of postoperative complications in the study group was lower,the operation time and hospitalization time were shorter,the intraoperative blood loss was less,and the surgical incision was smaller,the differences were statistically significant(all P<0.05).After treatment,compared with the control group,the levels of neuron-specific enolase and S100βprotein,interleukin-2,interleukin-6 and tumor necrosis factor-αin the study group were lower,and the level of brain-derived neurotrophic factor the scores of eye opening response,oral response and motor response were higher,and the differences were statistically significant(all P<0.05).Conclusion Endoscopic minimally invasive surgery in the treatment of HCH has good effect,low incidence of complications,good recovery of neurological function,and can reduce inflammatory injury.

关 键 词：高血压脑出血 内镜下微创手术 小骨窗开颅术 神经功能 炎症 

分 类 号：R651[医药卫生—外科学]