冠状缝前入路神经内镜手术对高血压基底节区脑出血患者神经功能及并发症影响

Effects of anterior coronary suture neuroendoscopy on neurological function and complications in patients with hypertensive basal ganglia cerebral hemorrhage

目的目前,临床上在治疗高血压基底节区脑出血患者时常行开颅血肿清除术治疗,但该术式创面大、易感染,不利于预后,而随着神经内镜技术水平的提升,冠状缝前入路神经内镜手术也逐渐应用至该病症治疗中,本研究探讨冠状缝前入路神经内镜手术对高血压基底节区脑出血患者神经功能及并发症影响。方法以本院2018-07-01-2019-07-01收治的高血压基底节区脑出血患者为研究对象,根据观察组的性别、年龄、高血压病程和血肿容积,选择与之匹配的行开颅血肿清除手术治疗的30例患者为对照组,观察并比较两组患者术后神经功能、手术指标及并发症发生情况。结果治疗后,观察组美国国立卫生研究院卒中量表评分(National Institute of Health stroke scale,NIHSS)为(14.63±3.14)分,低于对照组的(14.63±3.14)分,t=8.079,P<0.001。观察组手术时间为(47.61±6.73)min,短于对照组的(63.17±7.64)min,t=8.371,P<0.001;观察组术中出血量为(38.21±3.17)mL,少于对照组的(42.41±4.68)mL,t=4.070,P<0.001;观察组ICU住院时间为(5.17±1.31)min,短于对照组的(8.37±1.52)min,t=8.735,P<0.001。观察组并发症发生率为3.33%,低于对照组的26.67%,差异有统计学意义,χ~2=4.706,P=0.030。结论临床上治疗高血压基底节区脑出血患者时,采取冠状缝前入路神经内镜手术的效果较好,可以有效改善患者神经功能,缩短手术及ICU住院时间,减少术中出血量,并降低并发症发生风险。

OBJECTIVE At present,craniotomy hematoma removal is often used in the treatment of patients with hypertensive basal ganglia cerebral hemorrhage.However,the surgical wound is large and easily infected,which is not conducive to prognosis.With the improvement of neuroendoscopic technology,anterior coronary sutures approach neuroendoscopy is also gradually applied to the treatment of this disease.This study investigated the effect of anterior coronary suture approach neuroendoscopy on neurological function and complications in patients with hypertensive basal ganglia cerebral hemorrhage.METHODS Thirty patients with hypertensive basal ganglia cerebral hemorrhage treated in our hospital from July 1,2018 to July 1,2019 as the research object.According to the gender,age,duration of hypertension,and hematoma volume of the observation group,30 cases with cranial hematoma removal were selected as the control group.The neurological function,surgical indicators and complications of the two groups were observed and compared.RESULTS After treatment,the National Institute of Health stroke scale(NIHSS)score in the observation group was(14.63±3.14)points,which was lower than the control group(14.63±3.14)points,t=8.079,P<0.001.The operation time in the observation group was(47.61±6.73)min,which was shorter than the control group(63.17±7.64)min,t=8.371,P<0.001.The intraoperative blood loss in the observation group was(38.21±3.17)ml,which was shorter than that of the control group(42.41±4.68)ml,t=4.070,P<0.001.The length of ICU stay in the observation group was(5.17±1.31)min,which was shorter than that of the control group(8.37±1.52)min,t=8.735,P<0.001.The incidence of complications in the observation group was 3.33%,which was lower than 26.67%of the control group.The difference was statistically significant,χ~2=4.706,P=0.030.CONCLUSION In the clinical treatment of hypertensive patients with cerebral hemorrhage in the basal ganglia,neuroendoscopy with anterior coronary suture approach has better results,can effectively improve the patient’s neurological function,shorten the length of surgery and ICU hospitalization,reduce intraoperative bleeding and the risk of complications.