摘要
目的观察神经内镜下经额叶入路血肿清除术对高血压性脑出血患者脑血流灌注以及短期预后的影响。方法采用前瞻性随机对照研究,选择2020年6月至2022年6月驻马店市中医院需行神经内镜下血肿清除术治疗的79例高血压性脑出血患者作为研究对象,采用随机数字表法将患者分为A组与B组,其中A组接受神经内镜下经额叶入路血肿清除术治疗,B组接受神经内镜下经颞叶皮质血肿清除术治疗。比较两组患者术后2个月短期疗效、围手术期指标(手术时间、术中出血量、血肿清除率、住院时间)、脑血流灌注指标[局部脑血流量(rCBF)、对比剂平均通过时间(MTT)、局部脑血容量(rCBV)]以及术后并发症。结果A组患者术后2个月临床疗效优于B组,A组患者血肿清除率高于B组,差异有统计学意义(P<0.05)。两组患者住院时间、术中出血量、手术时间方面比较,差异无统计学意义(P>0.05)。术前两组患者rCBV、rCBF以及MTT比较,差异无统计学意义(P>0.05);术后两组患者rCBV、rCBF均上升,MTT均下降,且A组与B组相比,差异有统计学意义(P<0.05)。两组患者均出现术后并发症,但组间比较差异无统计学意义(P>0.05)。结论神经内镜下经额叶入路血肿清除术可有效提高高血压性脑出血患者短期疗效及血肿清除率,改善颅脑血供情况。
Objective To observe the effect of endoscopic transfrontal approach hematoma removal surgery on cerebral blood perfusion and short-term prognosis in patients with hypertensive cerebral hemorrhage.Methods A prospective randomized controlled study was conducted,selecting hypertensive cerebral hemorrhage patients who underwent neuroendoscopic hematoma removal surgery at Zhumadian TCM Hospital from June 2020 to June 2022 as the study subjects.The patients were divided into group A and group B using a random number table method.Group A received neuroendoscopic transfrontal hematoma removal surgery,while group B received neuroendoscopic transtemporal cortical hematoma removal surgery.The short-term efficacy,perioperative indexes(operation time,intraoperative blood loss,hematoma clearance rate,hospitalization time),cerebral blood perfusion indexes[regional cerebral blood flow(rCBF),contrast agent mean transit time(MTT),regional cerebral blood volume(rCBV)]and postoperative complications were compared between the two groups.Results The clinical efficacy of group A was better than that of group B two months after surgery,and the hematoma clearance rate of group A was higher than that of group B,with a statistical significant difference(P<0.05).There was no statistical significant difference between the two groups in terms of hospital stay,intraoperative bleeding and surgical time(P>0.05).There was no statistical significant difference in rCBV,rCBF and MTT between the two groups of patients before surgery(P>0.05).After surgery,rCBV and rCBF increased and MTT decreased in both groups of patients,and the difference between group A and group B was statistically significant(P<0.05).Both groups of patients experienced postoperative complications,but there was no statistical significant difference between the groups(P>0.05).Conclusion Neuroendoscopic transfrontal approach hematoma clearance surgery can effectively improve the short-term efficacy and hematoma clearance rate in patients with hypertensive intracerebral hemorrhage,a
作者
徐四军
XU Sijun(The Second Department of Surgery,Zhumadian TCM Hospital,Zhumadian 463000,China)
出处
《河南医学研究》
CAS
2024年第5期864-868,共5页
Henan Medical Research
关键词
神经内镜
血肿清除术
高血压性脑出血
脑血流灌注
短期预后
neuroendoscopy
hematoma removal surgery
hypertensive cerebral hemorrhage
cerebral blood perfusion
short term prognosis
