神经内镜与锁孔显微治疗基底节脑出血的疗效对比研究

Clinical effect comparison research of neuro-endoscopy and keyhole micro-therapy using in basal ganglion hemorrhage

目的分析神经内镜与锁孔显微治疗基底节脑出血患者的临床疗效及安全性。方法选取南方医科大学顺德医院自2015年1月至2016年12月治疗的基底节脑出血患者62例。根据手术方案分为2组,内镜组(35例)采用神经内镜手术治疗,锁孔组(27例)采用锁孔显微手术治疗。比较2组患者手术用时、术中失血量、血肿清除率、住院时间等手术相关指标情况及并发症发生率,并对比术前、术后7 d GCS评分变化;术后6个月采用日常生活能力量表评估2组的预后情况。结果内镜组手术用时、住院时间短于锁孔组,术中失血量少于锁孔组,血肿清除率高于锁孔组,差异有统计学意义(P<0.05);内镜组并发症发生率低于锁孔组(5.71%vs. 29.63%),差异有统计学意义(P<0.05);术后7 d内镜组GCS评分等级优于锁孔组,差异有统计学意义(P<0.05);术后6个月,内镜组预后效果优于锁孔组,差异有统计学意义(P<0.05)。结论与锁孔显微手术相比,神经内镜治疗基底节脑出血可缩短手术用时、住院时间,减少术中失血量,提高血肿清除率及降低并发症发生率低。

Objective To evaluate the clinical effect and safety of neuro-endoscopy and keyhole micro-therapy using in basal ganglion hemorrhage.Methods Sixty two cases who were suffering from basal ganglion hemorrhage from Jan 1,2015 to Dec 31,2016 who were receiving treatment in Shunde Hospital of Southern Medical University were selected and divided into neuro-endoscopy group(n=35)and keyhole micro-therapy group(n=27)randomly.Then statistic and analysis the operation time,blood loss volume during operation,hematoma clearance rate,length of hospital stays and the other index of operation and complication occurrence rate,to compare the GCS variation before operation and 7 d after operation.After 6 months,comparing the prognosis between these two groups using activity of daily living scale.Results The operation time and length of hospital stays are shorter,the blood loss volume is much less,and the hematoma clearance rate is higher,in neuro-endoscopy group than keyhole micro-therapy group significantly(P<0.05).The complication occurrence rate in neuro-endoscopy group is much less than keyhole micro-therapy group(5.71%vs.29.63%)(P<0.05).Seven days after operation,the GCS status in neuro-endoscopy group is better than keyhole micro-therapy group significantly(P<0.05);6 months after operation,the prognosis in neuro-endoscopy group is better than keyhole micro-therapy group significantly(P<0.05).Conclusion Comparing to keyhole micro-therapy,neuro-endoscopy could shorten operation time and length of hospital stays,reduce blood loss volume during operation,increase hematoma clearance rate,reduce complication occurrence rate when using in basal ganglion hemorrhage.