神经内镜血肿清除术与立体定向血肿抽吸术治疗高血压性脑出血的随机对照研究

Randomized controlled study between neural endoscopic hematoma evacuation surgery and stereotactic aspiration surgery for hypertensive intracerebral hemorrhage

目的观察神经内镜血肿清除术与立体定向抽吸术治疗高血压性脑出血的疗效,为临床治疗高血压脑出血提供参考依据。方法将120例高血压性脑出血患者随机分为试验组和对照组各60例,试验组行神经内镜血肿清除术,对照组行立体定向抽吸术,比较2组治疗效果。结果试验组血肿清除率高于对照组,肺部感染发生率显著低于对照组,术后3 d平均格拉斯哥昏迷评分明显高于对照组;试验组术后12个月格拉斯哥预后量表评分以及术后3、6、12个月的活动能力状况均高于对照组(P<0.05)。结论神经内镜血肿清除术治疗高血压性脑出血的近期和远期疗效均优于立体定向抽吸术,值得在临床上推广应用。

Objective To evaluate the curative effect of neural endoscopic hematoma evacuation surgery and stereotactic aspiration surgery for hypertensive intracerebral hemorrhage.Methods One hundred and twenty cases of hypertensive intracerebral hemorrhage patients in the hospital were randomly divided into experimental group（n=60） and control group（n=60）,experimental group was given CT-guided neural endoscopic surgery,control group stereotactic aspiration surgery.The curative effect was compared between two groups.Results The hematoma evacuation rate of experimental group was higher than that of control group,the incidence of pulmonary infection of experimental group was significantly lower than that of control group.At 3d after operation,the average Glasgow coma scale of experimental group was significantly higher than that of control group;Glasgow outcome scale 12 months after surgery and barthel index 3,6,12 months after surgery of experimental group were higher than those of control group（P〈0.05）.Conclusion Recent efficacy and long-term efficacy of endoscopic hematoma evacuation surgery for hypertensive cerebral hemorrhage are superior to those of stereotactic aspiration,which deserves populization in clinic.