神经内镜微创术与微创钻孔引流术治疗高血压脑出血的临床效果与安全性分析

Clinical efficacy and safety between endoscopic minimally invasive surgery and minimally invasive drainage for hypertensive cerebral hemorrhage

目的对比分析神经内镜微创手术与微创钻孔引流术治疗高血压脑出血的临床效果与安全性。方法收集2017年1月-2017年12月该院神经外科收治的90例高血压脑出血患者的病历资料,进行回顾性分析。根据手术方式不同分为A组(47例,行神经内镜微创手术)和B组(43例,行微创钻孔引流手术),比较两组患者的手术时间、术中出血量、血肿清除率、住院时间、术后并发症发生情况及预后情况。结果 B组手术时间和术中出血量明显少于A组,A组血肿清除率(92.84±4.73)%明显高于B组(87.52±5.39)%,差异具有统计学意义(P <0.05)。两组术后住院时间、再出血发生率、并发症发生率和死亡率比较,差异均无统计学意义(P>0.05)。术后3个月与术前比较,两组的美国国立卫生研究院脑卒中评分量表(NIHSS)均明显降低,日常生活活动评分(ADL)均明显升高,两组比较,差异均无统计学意义(P>0.05)。A组和B组术后6个月预后良好率分别为93.62%和83.72%,组间比较差异无统计学意义(P>0.05)。结论神经内镜微创术可提高血肿清除效果,微创钻孔引流术可缩短手术时间,减少术中出血量,两者均安全、可靠,且预后较好。

Objective To compare and analyze the clinical efficacy and safety between endoscopic minimally invasive surgery and minimally invasive drainage for hypertensive cerebral hemorrhage. Methods The clinical data of 90 cases patients with hypertensive cerebral hemorrhage from January 2017 to December 2017 were collected and retrospectively analyzed. According to the different surgical methods, all the 90 cases patients were divided into A group (47 cases, underwent endoscopic minimally invasive surgery) and B group (43 cases, underwent minimally invasive drainage). The operation time, bleeding volume, clearance of hematoma, hospital stay, postoperative complication and prognosis conditions were compared between the two groups. Results The operation time in the B group was significantly shorter than that in the A group, and the bleeding volume in the B group was significantly less than that in the A group, and the clearance of hematoma in the A group (92.84 ± 4.73)% was significantly higher than that in the B group (87.52 ± 5.39)%, all above had statistical difference (P < 0.05). There was no statistical difference in the hospital stay, recurrence rate, complication rate and mortality rate between two groups (P > 0.05). At 3 months after operation, the NIHSS scores were significantly decreased and the ADL scores were significantly increased before operation, all above had statistical difference (P < 0.05), there was no significant difference between the two groups (P > 0.05) while there was no statistical difference in the NIHSS and ADL scores between the two groups (P > 0.05). Conclusion The endoscopic minimally invasive surgery could improve the removal of hematoma, and the minimally invasive drainage could shorten operative time and reduce intraoperative blood loss. Both the two methods are safe, reliable and have good prognosis.