神经内镜微创手术与小骨窗开颅显微手术治疗幕上高血压脑出血的临床效果

Clinical Effect of Endoscopic Minimally Invasive Surgery and Small Bone Window Craniotomy Microsurgery in Treatment of Supratentorial Hypertensive Intracerebral Hemorrhage

目的比较神经内镜微创手术与小骨窗开颅显微手术治疗幕上高血压脑出血的疗效。方法选择2015年6月—2016年3月接受手术治疗的幕上高血压脑出血72例,根据手术方式分为观察组39例和对照组33例,观察组采取神经内镜微创手术,对照组采取小骨窗开颅显微手术。比较2组手术情况、术后及预后情况。结果观察组术中出血量少于对照组,手术时间和入住ICU时间短于对照组(P<0.05)。观察组血肿清除率、预后良好率高于对照组,并发症发生率低于对照组(P<0.05)。观察组术后神经功能缺损评分较治疗前和对照组降低,日常生活能力评分高于治疗前和对照组(P<0.05)。结论神经内镜微创手术治疗幕上高血压脑出血临床疗效优于小骨窗开颅显微手术,能缩短治疗时间,促进神经功能恢复,改善预后。

Objective To compare clinical effect between endoscopic minimally invasive surgery and small bone window craniotomy microsurgery in treatment of supratentorial hypertensive intracerebral hemorrhage. Methods A total of 72 patients with supratentorial hypertensive intracerebral hemorrhage for surgery treatment during June 2015 and March 2016 were divided into observation group （n = 39） and control group （n = 33） according to different operative methods. Observation group was treated with minimally invasive endoscopic surgery, while control group was treated with small bone window craniotomy microsurgery. Conditions of operation, afteroperation and prognosis were observed in two groups. Results Compared with those in control group, in observation group, intraoperative bleeding volume was less, operative time and ICU stay time were significantly shorter compared with those in control group （P 〈 0. 05）. In observation group, hematoma clearance rate and excellent and good rate of prognosis were significantly higher, while incidence rate of complications was significantly lower than that in control group （P 〈 0.05 ） ; postoperative China stroke scale （CSS） score was significantly lower, while activities of daily living （ADL） score was significantly higher than that before treatment and in control group （P 〈 0.05）. Conclusion Endoscopic minimally invasive surgery in treatment of supratentorial hypertensive intracerebral hemorrhage can achieve better clinical effect than that by small bone window craniotomy microsurgery, and it can also shorten therapeutic time, promote the recovery of neurological function and improve prognosis of patients.