摘要
目的分析小骨窗开颅神经内镜下辅助颅内血肿清除术治疗高血压性基底节区中等量出血患者的临床效果。方法选取2019年3月至2021年3月天水市第一人民医院收治的68例高血压性基底节区中等量出血患者为研究对象,根据治疗方法不同分为观察组和对照组,各34例。对照组采取小骨窗开颅颅内血肿清除术治疗,观察组采用小骨窗开颅神经内镜下辅助颅内血肿清除术治疗。比较两组患者手术时间、术中出血量及血肿清除率。随访6个月,比较两组患者手术前后神经功能[美国国立卫生研究院卒中量表(NIHSS)评分]、运动功能(Fugl-Meyer评分)、格拉斯哥预后评分(GOS)、格拉斯哥昏迷评分(GCS),记录患者术后再出血及并发症发生情况。结果观察组患者手术时间短于对照组[(92±12)min比(115±16)min],术中出血量少于对照组[(85±6)ml比(103±9)ml],血肿清除率高于对照组[(86±10)%比(63±7)%](P<0.05或P<0.01)。NIHSS评分和Fugl-Meyer评分时点间、组间的主效应差异有统计意义(P<0.01),组间和时点间存在交互作用(P<0.05或P<0.01),术后3个月、6个月,两组患者NIHSS评分呈下降趋势,Fugl-Meyer评分呈升高趋势(P<0.05),且观察组NIHSS评分低于对照组,Fugl-Meyer评分高于对照组(P<0.05)。GOS和GCS评分时点间、组间的主效应差异有统计意义(P<0.01),组间和时点间存在交互作用(P<0.05或P<0.01);术后3个月、6个月,两组患者GOS和GCS评分呈升高趋势(P<0.05),且观察组GOS和GCS评分高于对照组(P<0.05)。观察组患者术后再出血发生率低于对照组[5.88%(2/34)比25.53%(8/34)](χ^(2)=4.221,P=0.040),并发症总发生率低于对照组[8.82%(3/34)比29.41%(10/34)](χ^(2)=4.660,P=0.031)。结论采取小骨窗开颅神经内镜下辅助颅内血肿清除术治疗高血压性基底节区中等量出血患者的临床效果较好,可缩短患者手术时间、减少术中出血量,提高血肿清除率,促进患者神经及运动功能恢�
Objective To analyze the clinical effect of intracranial hematoma removal in patients with hypertensive moderate hemorrhage in the basal ganglia area by neuroendoscope assisted small bone window craniotomy.Methods A total of 68 patients with moderate amount of hypertensive basal ganglia hemorrhage admitted to the First People′s Hospital of Tianshui from Mar.2019 to Mar.2021 were included and divided into an observation group and a control group according to different treatment methods,34 cases in each group.The control group was treated with small bone window craniotomy,and the observation group was treated with neuroendoscope assisted small bone window craniotomy,for removal of intracranial hematoma.The operation time,intraoperative blood loss and hematoma clearance rate were compared between the two groups.The patients were followed up for 6 months,and the neurological function[National Institute of Health stroke scale(NIHSS)score],motor function(Fugl-Meyer score),Glasgow prognostic score(GOS),Glasgow coma score(GCS)were compared before and after surgery between the two groups.And the postoperative rebleeding and complications were recorded.Results The operation time of the observation group was shorter than that of the control group[(92±12)min vs(115±16)min],the intraoperative blood loss was less than that of the control group[(85±6)ml vs(103±9)ml],and the hematoma clearance rate was higher than that of the control group[(86±10)%vs(63±7)%](P<0.05 or P<0.01).There were statistically significant differences in the main effect of NIHSS score and Fugl-Meyer score between time points and groups(P<0.01),and there were interactions between groups and time points(P<0.05 or P<0.01).At 3 and 6 months after surgery,NIHSS score of the two groups showed a downward trend,the Fugl-Meyer score showed an increasing trend(P<0.05),and the NIHSS score of the observation group was lower than that of the control group,while the Fugl-Meyer score was higher than that of the control group(P<0.05).There were statistically signi
作者
王鹏
王晓曦
牛祥
赵自育
WANG Peng;WANG Xiaoxi;NIU Xiang;ZHAO Ziyu(Department of Neurosurgery,the First People′s Hospital of Tianshui,Tianshui 741000,China)
出处
《医学综述》
CAS
2023年第14期2903-2907,共5页
Medical Recapitulate
基金
天水市科技支撑计划项目(2021-SHFZKJK-2889)。
关键词
高血压性基底节区中等量出血
小骨窗开颅术
神经内镜
Hypertensive moderate hemorrhage in the basal ganglia area
Small bone window craniotomy
Neuroendoscope
