摘要
目的:探讨小骨窗开颅血肿清除术与经额中回入路透明套管下神经内镜手术治疗高血压脑出血(HICH)的效果。方法:回顾性分析2020年6月—2022年6月在远安县人民医院实施手术治疗的84例HICH患者的临床资料。根据不同手术方法将其分为开颅组和内镜组,各42例。开颅组实施小骨窗开颅血肿清除术,内镜组实施经额中回入路透明套管下神经内镜手术。比较两组临床疗效,围手术期指标,术前和术后24 h的颅内压,术前及术后3个月神经功能、日常生活活动能力,预后情况及并发症。结果:内镜组总有效率为高于开颅组,差异有统计学意义(P<0.05)。两组手术时间比较,差异无统计学意义(P>0.05);内镜组术中出血量、术后残留血肿量均少于开颅组,血肿清除率高于开颅组,术后ICU时间短于开颅组,差异有统计学意义(P<0.05)。术后24 h,内镜组颅内压低于开颅组,术后3个月美国国立卫生研究院卒中量表(NIHSS)评分低于开颅组,Barthel指数(BI)评分高于开颅组,差异有统计学意义(P<0.05)。内镜组预后情况优于开颅组,差异有统计学意义(P<0.05)。内镜组术后并发症发生率低于开颅组,差异有统计学意义(P<0.05)。结论:经额中回入路透明套管下神经内镜手术可提高HICH患者临床疗效,促进术后恢复,改善神经功能和日常生活活动能力。
Objective:To investigate the effect of small bone window craniotomy hematoma removal and trans-middle frontal gyrus approach transparent cannula neuroendoscopic surgery in the treatment of hypertensive intracerebral hemorrhage(HICH).Method:The clinical data of 84 patients with HICH who underwent surgical treatment in Yuan’an County People's Hospital from June 2020 to June 2022 were retrospectively analyzed.According to different surgical methods,they were divided into craniotomy group and endoscope group,42 cases in each group.Small bone window craniotomy hematoma removal was performed in the craniotomy group,and trans-middle frontal gyrus approach transparent cannula neuroendoscopic surgery was performed in the endoscope group.The clinical efficacy,perioperative indexes,intracranial pressure before and 24 h after surgery,neurological function and activity of daily living ability before and 3 months after surgery,prognosis condition and complications were compared between two groups.Result:The total effective rate of endoscope group was higher than that of craniotomy group,and the difference was statistically significant(P<0.05).There was no significant difference in surgery time between the two groups(P>0.05).The amount of intraoperative blood loss and postoperative residual hematoma in endoscope group were less than that in craniotomy group,the clearance rate of hematoma was higher than that in craniotomy group,and the postoperative ICU time was shorter than that in craniotomy group,the differences were statistically significant(P<0.05).At 24 h after surgery,the intracranial pressure in endoscope group was lower than that in craniotomy group,the National Institute of Health stroke scale(NIHSS)score at 3 months after surgery was lower than that in craniotomy group,and the Barthel index(BI)score was higher than that in craniotomy group,the differences were statistically significant(P<0.05).The prognosis condition of endoscope group was better than that of craniotomy group,and the difference was statistically si
作者
温理军
吴丁娟
肖步云
张万林
WEN Lijun;WU Dingjuan;XIAO Buyun;ZHANG Wanlin(Yuan’an County People's Hospital,Yuan’an 444299,China;不详)
出处
《中外医学研究》
2023年第19期121-124,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
高血压脑出血
小骨窗开颅血肿清除术
经额中回入路透明套管下神经内镜手术
预后
Hypertensive intracerebral hemorrhage
Small bone window craniotomy hematoma removal
Trans-middle frontal gyrus approach transparent cannula neuroendoscopic surgery
Prognosis
