神经内窥镜与穿刺引流术治疗基底节区自发性高血压脑出血的临床比较

Clinical comparison of neuroendoscopy and puncture drainage for the treatment of spontaneous hypertensive intracerebral hemorrhage in basal ganglia

目的比较神经内窥镜与穿刺引流术治疗基底节区自发性高血压脑出血的临床效果。方法 82例基底节区自发性高血压脑出血患者,按照手术方法不同分为观察组(42例)和对照组(40例)。观察组患者接受神经内窥镜术治疗,对照组患者接受穿刺引流术治疗。比较两组的临床效果。结果观察组术后7 d颅内压低于对照组,术后3 d血肿清除率高于对照组,术后住院时间短于对照组,差异均有统计学意义(P<0.05)。观察组术后3个月改良Rankin量表评分(m RS)为(1.8±0.7)分,对照组为(2.0±0.9)分,比较差异无统计学意义(P>0.05)。观察组术后3个月格拉斯哥预后评分(GOS)优于对照组,差异有统计学意义(P<0.05)。观察组术后发生并发症4例,少于对照组的9例,但差异无统计学意义(P>0.05)。结论神经内窥镜治疗基底节区自发性高血压脑出血血肿消除较快,颅内压下降更明显,预后效果更佳。

Objective To compare the clinical effect of neuroendoscopy and puncture drainage for the treatment of spontaneous hypertensive intracerebral hemorrhage in basal ganglia. Methods A total of 82 patients with spontaneous hypertensive intracerebral hemorrhage in basal ganglia were divided into observation group for 42 cases and control group for 40 cases according to different surgical methods. Patients in the observation group received neuroendoscopy therapy, patients in the control group received puncture drainage for treatment. The clinical effects of the two groups were compared. Results The intracranial pressure of the observation group after 7 d of surgery was significantly lower than that of the control group, the clearance rate of hematoma in the observation group after 3 d of surgery was significantly higher than that in the control group, and the postoperative length of stay was significantly shorter than that of the control group, the differences were statistically significant （P〈0.05）. The modified Rankin scale score （mRS） of the observation group was （1.8 ± 0.7） scores, that of the control group was （2.0 ±0.9） scores, there was no statistically significant difference （P〉0.05）. The Glasgow outcome scale （GOS） of the observation group after 3 months of surgery was significantly better than that of the control group, the difference was statistically significant （P〈0.05）. There were 4 cases of postoperative complications in the observation group, which was less than 9 cases in the control group, but the difference was not statistically significant （P〉O.05）. Conclusion The hematoma removal of neuroendoscopy for the treatment of spontaneous hypertensive intracerebral hemorrhage in basal ganglia is quicker, the intracranial pressure is decreased more significantly, the prognosis is better.