摘要
目的探究高血压性脑出血(HICH)患者采用神经内镜微创手术及小骨窗开颅显微手术治疗的效果。方法70例HICH患者,随机分为观察组和对照组,每组35例。对照组患者给予小骨窗开颅显微手术治疗,观察组患者给予神经内镜微创手术治疗。对比两组患者手术情况、手术前后各项评分及术后并发症发生情况。结果观察组的手术时间(1.47±1.02)h、重症加强护理病房(ICU)时间(5.07±1.62)d、住院总时间(8.67±3.64)d均短于对照组(3.07±1.22)h、(13.67±1.73)d、(15.74±4.71)d,术中出血量(45.67±14.62)ml、术后血肿残余量(7.42±1.52)ml均少于对照组的(325.43±54.75)、(15.67±2.43)ml,差异具有统计学意义(P<0.05)。术前,两组的美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(MRS)评分和格拉斯哥昏迷指数量表(GCS)评分比较差异无统计学意义(P>0.05);术后,观察组的NIHSS评分(10.97±2.32)分、MRS评分(0.49±0.46)分和GCS评分(13.82±1.26)分均显著优于对照组的(18.24±4.19)、(2.38±1.09)、(9.90±2.23)分,差异具有统计学意义(P<0.05)。观察组患者的术后并发症发生率2.86%显著低于对照组的17.14%,差异具有统计学意义(P<0.05)。结论在HICH患者的治疗中,神经内镜微创手术更具微创优势,可有效缩短手术时间,减少术中出血量,降低术后血肿残余量,缩短住院时间,降低病死率和并发症,加强预后水平,值得广大医师和患者采纳。
Objective To investigate the effect of neuroendoscopic minimally invasive surgery and small bone window craniotomy for the treatment of hypertensive intracerebral hemorrhage(HICH).Methods A total of 70 HICH patients were randomly divided into observation group and control group,with 35 cases in each group.Patients in the control group were treated with small bone window craniotomy,and patients in the observation group were treated with neuroendoscopic minimally invasive surgery.The surgical conditions,scores before and after surgery,and postoperative complications were compared between the two groups.Results The operation time(1.47±1.02)h,intensive care unit(ICU)duration(5.07±1.62)d,and total hospitalization time(8.67±3.64)d of the observation group were shorter than(3.07±1.22)h,(13.67±1.73)d,and(15.74±4.71)d of the control group,and the intraoperative blood loss(45.67±14.62)ml and postoperative hematoma residual volume(7.42±1.52)ml were less than(325.43±54.75)and(15.67±2.43)ml of the control group.All the differences were statistically significant(P<0.05).Before surgery,the difference in the scores of National Institutes of Health stroke scale(NIHSS),Modified Rankin scale(MRS)and Glasgow coma scale(GCS)between the two groups were not statistically significant(P>0.05).After surgery,the NIHSS score(10.97±2.32)points,MRS score(0.49±0.46)points,and GCS score(13.82±1.26)points of the observation group were significantly better than(18.24±4.19),(2.38±1.09),and(9.90±2.23)points of the control group,and the difference was statistically significant(P<0.05).The postoperative complication rates in the observation group was 2.86%,which was significantly lower than 17.14% in the control group,and the difference was statistically significant(P<0.05).Conclusion In the treatment of patients with HICH,neuroendoscopic minimally invasive surgery is more minimally invasive,which can effectively shorten the operation time,reduce intraoperative blood loss,reduce postoperative residual hematoma,shorten the hospitalizat
作者
杨幸达
朱红
邹志斌
钟波
胡友珠
YANG Xing-da;ZHU Hong;ZOU Zhi-bin(Department of Neurosurgery,Xinyu People’s Hospital,Xinyu 338000,China)
出处
《中国实用医药》
2022年第7期17-20,共4页
China Practical Medicine
关键词
高血压性脑出血
神经内镜微创手术
小骨窗开颅显微手术
Hypertensive intracerebral hemorrhage
Neuroendoscopic minimally invasive surgery
Small bone window craniotomy
