摘要
目的观察不同血肿清除术治疗Fisher分级Ⅲ级丘脑出血的效果。方法前瞻性选取2018年1月至2023年1月安阳市人民医院收治的Fisher分级Ⅲ级丘脑出血患者154例为研究对象,根据随机数排序法分为对照组与研究组,各77例。研究组患者接受神经内镜下血肿清除术治疗,对照组接受开颅显微镜下血肿清除术治疗。比较两组疗效、神经血管相关因子[肝细胞生长因子(HGF)、脑源性神经营养因子(BDNF)、神经生长因子(NCF)]水平、并发症和预后情况。结果两组残余血肿量比较差异无统计学意义(P>0.05),研究组术中出血量少于对照组,住院时间短于对照组(P<0.05)。术后1周两组HGF水平降低,BDNF、NGF水平升高(P<0.05),且研究组HGF水平低于对照组,BDNF、NGF水平高于对照组(P<0.05)。两组再出血、颅内感染、肺部感染、癫痫、消化道出血发生率比较差异无统计学意义(P>0.05),但研究组总发生率低于对照组(P<0.05)。研究组术后1个月格拉斯哥昏迷评分(GOS)评分高于对照组,预后不良发生率低于对照组(P<0.05)。结论神经内镜下血肿清除术治疗丘脑出血效果确切,可有效提高患者神经功能,降低并发症发生风险,改善预后。
Objective To observe the effectiveness of different hematoma removal surgeries in the treatment of Fisher gradeⅢthalamic hemorrhage.Methods A total of 154 patients with Fisher gradeⅢthalamic hemorrhage admitted to Anyang People’s Hospital from January 2018 to January 2023 were prospectively selected as research objects,and they were divided into control group and study group according to random number sorting method,with 77 cases in each group.Patients in the study group were treated with hematoma clearance under neuroendoscope,and the control group were treated with hematoma clearance under craniotomy microscope.The curative effect,levels of neurovascular related factors[hepatocyte growth factor(HGF),brain-derived neurotrophic factor(BDNF),nerve growth factor(NCF)],complications,and prognosis were compared between the two groups.Results There was no statistical difference in the amount of residual hematoma between the two groups(P>0.05).The intraoperative bleeding in the study group was less than that in the control group,and the hospital stay was shorter than that in the control group(P<0.05).One week after surgery,HGF level decreased in both groups,while BDNF and NGF levels increased in the two groups(P<0.05).The HGF level in the study group was lower than those in the control group,while BDNF and NGF levels were higher than those in the control group(P<0.05).There was no statistical difference in the incidence of rebleeding,intracranial infection,pulmonary infection,epilepsy,and gastrointestinal bleeding between the two groups(P>0.05),but the overall incidence of the study group was lower than that of the control group(P<0.05).The Glasgow coma scale(GOS)score of the study group was higher than that of the control group one month after surgery,and the incidence of poor prognosis was lower than that of the control group(P<0.05).Conclusion Neuroendoscopic hematoma removal surgery has a definite effect on treating thalamic hemorrhage,which can effectively improve the patients’neurological function,reduce
作者
闫薇
牛江涛
金星
YAN Wei;NIU Jiangtao;JIN Xing(Department of Neurosurgery,Anyang People’s Hospital,Anyang 455000,China)
出处
《河南医学研究》
CAS
2023年第13期2409-2412,共4页
Henan Medical Research
关键词
丘脑出血
神经内镜下血肿清除术
开颅显微镜下血肿清除术
疗效
thalamic hemorrhage
neuroendoscopic hematoma removal
removal of hematoma under craniotomy microscope
efficacy
