摘要
目的探讨不同术式对基底节区高血压脑出血(HICH)患者围术期指标、血清神经特异性烯醇化酶(NSE)、前白蛋白(PA)水平、神经功能及术后并发症的影响。方法纳入南京市溧水区人民医院2021年1月至2023年1月收治入院并接受手术治疗的83例基底节区HICH患者资料,其中43例患者接受导航辅助神经内镜硬通道微创治疗(内镜组),余40例接受小骨窗开颅血肿清除术治疗(开颅组)。对两组围术期指标、手术前后的血清NSE、PA水平、美国国立卫生院卒中量表(NIHSS)评分及术后并发症进行统计分析。结果与开颅组相比,内镜组手术时间较长,出血量较少,血肿清除率较高,ICU入住时间较短,差异有统计学意义(t=8.504、8.332、10.222、9.180,P<0.05)。与术前相比,两组术后7 d血清NSE、NIHSS评分明显降低(t=28.137、19.333、30.472、16.683,P<0.05),且内镜组术后7 d的血清NSE及NIHSS评分明显低于对照组,差异有统计学意义(t=3.775、10.113,P<0.05)。与术前相比,两组术后7 d血清PA明显升高(t=-13.077、-9.189,P<0.05),且内镜组术后7 d的血清PA明显高于开颅组,差异有统计学意义(t=3.541,P<0.05)。内镜组术后并发症总发生率为9.30%,较开颅组的30.00%更低,差异有统计学意义(χ^(2)=5.705,P<0.05)。结论导航辅助神经内镜硬通道微创血肿清除术治疗基底节区HICH具有微创、高效、术后神经功能恢复好、并发症少特点,相比小骨窗开颅血肿清除术更具有优势。
Objective To explore the effects of different surgical methods on perioperative indicators,serum neurospecific enolase(NSE)and prealbumin(PA)levels,neurological function,and postoperative complications in patients with hypertensive intracerebral hemorrhage(HICH)in the basal ganglia region.Methods The data of 83 patients with HICH in the basal ganglia region who received surgical treatment in Nanjing Lishui People's Hospital from January 2021 to January 2023 were collected.Among them,43 patients received navigation-assisted neuroendoscopic hard channel minimally invasive treatment(endoscopic group),and the remaining 40 patients received small bone window craniotomy hematoma removal(craniotomy group).The perioperative indexes,serum NSE and PA levels before and after operation,the National Institutes of Health Stroke Scale(NIHSS)score and postoperative complications in the two groups were statistically analyzed.Results Compared with the craniotomy group,the endoscopic group had longer operation time,less blood loss,higher hematoma clearance rate,and shorter ICU stay.The differences between groups were statistically significant(t=8.504,8.332,10.222,9.180,P<0.05).Serum NSE and NIHSS scores in the two groups were significantly lower on day 7 after surgery than before surgery,and the differences were statistically significant(t=28.137,19.333,30.472,16.683,P<0.05).Serum NSE and NIHSS scores in the endoscopic group were significantly lower than those in the craniotomy group on day 7 after surgery,and the differences were statistically significant(t=3.775,10.113,P<0.05).Serum PA in the two groups were significantly higher on day 7 after surgery than before surgery,and the differences were statistically significant(t=-13.077,-9.189,P<0.05).Serum PA in the endoscopic group was significantly higher than that in the craniotomy group on day 7 after surgery than before surgery,and the difference was statistically significant(t=3.541,P<0.05).The total incidence of postoperative complications in the endoscopic group was 9.30%,sign
作者
叶亮亮
周立田
焦磊
丁俊宏
余前
刘维军
杨平来
YE Liangliang;ZHOU Litian;JIAO Lei;DING Junhong;YU Qian;LIU Weijun;YANG Pinglai(Neurosurgery Department,Nanjing Lishui People's Hospital/Zhongda Hospital Lishui Branch,Southeast University,Nanjing,Jiangsu,China,211299)
出处
《分子诊断与治疗杂志》
2024年第1期162-165,共4页
Journal of Molecular Diagnostics and Therapy
基金
南京市卫生科技发展专项基金项目(YKK20176)。
关键词
基底节区
高血压脑出血
神经内镜
导航
小骨窗血肿清除术
神经特异性烯醇化酶
前白蛋白
Basal ganglia region
Hypertensive intracerebral hemorrhage
Neuroendoscope
Navigation
Small bone window hematoma removal
Neurospecific enolase
Prealbumin
