神经内镜锁孔手术治疗基底节区脑出血

Keyhole endoscopic evacuation of basal ganglia hemorrhage

目的比较锁孔内镜和开颅治疗基底节区脑出血的效果。方法回顾性比较锁孔内镜组28例和传统开颅组30例基底节区脑出血的临床资料,比较两组血肿清除率、感染率和再出血率,术后3个月采用GOS评分对两组预后进行评价。结果锁孔内镜组血肿清除率明显高于开颅组(92.1%±3.9%vs 86.5%±9.1%,t=3.007,P=0.004),锁孔内镜组手术时间明显少于开颅组(138 min±15 min vs 232 min±16 min,t=-23.041,P=0.000),锁孔内镜组感染率显著低于开颅组(21.4%vs 50.0%,χ~2=5.119,P=0.024)。两组术后GOS预后评分无显著性差异(Z=-1.754,P=0.079)。结论锁孔内镜是一种治疗脑出血安全、可靠的手术方法。

Objective The clinical outcomes of keyhole endoscopy surgery and craniotomy for basal ganglia HICH were discussed. Methods The clinical data of 28 cases undergoing keyhole endoscopic surgery and 30 cases udnergoing craniotomy were analyzed retrospectively. Hematoma evacuation rate, infection rate, rebleeding rate and wean operation time were recorded as primary end points. Glasgow outcome scale （GOS） were recorded 3 months after operation. Results The evacuation rate in craniotomy group was significantly higher than that of the endoscopy group （92.1% ±3.9% vs 86.5% ±9.1%, t =3.007, P =0.004）, and the mean operation time in the endoscopy group was significantly less than that of the craniotomy group （138 min ± 15 min vs 232 min ＋ 16 min, t = - 23.041, P =0. 000）. The infection rate was lower in the endoscopy group compared with the craniotomy group （21.4% vs 50.0%, χ^2 =5.119,P =0.024）, and there was no significant difference in GOS between two groups after 3 months （Z = - 1.754, P =0. 079）. Conclusion The data indicate that keyhole endoscopic surgery is safe and feasible for the patients with ICH.