软性神经内镜辅助治疗应用于慢性硬膜下血肿患者的临床效果

Clinical Effect of Soft Neuroendoscope Assisted Therapy in Patients with Chronic Subdural Hematoma

目的探讨软性神经内镜辅助治疗在慢性硬膜下血肿(CSDH)患者中的应用效果.方法选取2020年3月—2021年11月我院收治的82例CSDH患者,按随机数字表法分为两组,各41例.对照组予以颅骨钻孔引流术治疗,观察组予以软性神经内镜辅助治疗,两组均随访6个月.比较两组围术期指标、神经功能、日常生活能力、生活质量、血肿复发率及并发症发生率.结果观察组术后1 d血肿清除率(92.35±4.25)%高于对照组,差异有统计学意义(P<0.05);观察组术后1个月中国脑卒中患者临床神经功能缺损程度评分量表评分、美国国立卫生研究院卒中量表评分均低于对照组,Barthel指数评定量表评分高于对照组,组间差异有统计学意义(P<0.05);观察组术后6个月世界卫生组织生存质量测定简表中生理、心理、社会及环境领域评分均高于对照组,组间差异有统计学意义(P<0.05);观察组血肿复发率2.44%(1/41)低于对照组,差异有统计学意义(P<0.05);两组并发症发生率相比,差异无统计学意义(P>0.05).结论软性神经内镜辅助治疗用于CSDH患者中疗效确切,有助于患者神经功能恢复,减轻疾病对日常生活能力及生活质量的影响,减少血肿复发,安全可靠.

Objective To investigate the application effect of soft neuroendoscope assisted therapy in patients with chronic subdural hematoma(CSDH).Methods 82 patients with CSDH admitted to our hospital from March 2020 to November 2021 were selected and divided into two groups according to the random number table method,with 41 patients in each group.The control group was treated with skull drilling and drainage,while the observation group was treated with soft neuroendoscope assisted therapy,and both groups were followed up for 6 months.The perioperative indicators,neurological function,daily living ability,quality of life,hematoma recurrence rate and incidence of complications were compared between the two groups.Results The hematoma clearance rate(92.35±4.25)%in the observation group at 1 day after surgery was higher than that in the control group,with statistically significant difference(P<0.05);the China stroke scale and National Institutes of Health stroke scale scores in the observation group at 1 month after surgery were lower than those in the control group,and the Barthel index score was higher than that in the control group,with statistically significant differences between the groups(P<0.05);the physiology,psychology,society and environment field scores in World Health Organization quality of life scalebrief scale in the observation group were higher than those in the control group,with statistically significant differences between the groups(P<0.05);the hematoma recurrence rate 2.44%(1/41)in the observation group was lower than that in the control group,with statistically significant difference(P<0.05);there was no significant difference in incidence of complications between the two groups(P>0.05).Conclusion Soft neuroendoscope assisted therapy can enhance the therapeutic effect in patients with CSDH,help patients recover their neurological function,reduce the impact of disease on their daily living ability and quality of life,and reduce the hematoma recurrence,which is safe and reliable.