神经内镜与小骨窗开颅手术治疗高血压脑出血临床分析

Clinical analysis of neuroendoscopic and small bone window craniotomy for hypertensive intracerebral hemorrhage

目的比较神经内镜与小骨窗开颅手术治疗高血压脑出血(HICH)治疗效果和并发症发生率。方法选取2016年7月至2017年12月期间HICH患者82例,随机分为神经内镜及小骨窗两组,每组41例,分别应用神经内镜与小骨窗开颅清除颅内血肿,然后对两组的手术时间、术中出血量、血肿清除率、GOS评分进行比较。结果神经内镜组手术切口长度、手术时间、术中出血量及手术并发症低于小骨窗开颅组,而血肿清除率高于小骨窗开颅组(P<0.05)。结论神经内镜治疗HICH较小骨窗开颅手术用时更短,血肿清除率及GOS评分更高,为颅内出血微创治疗提供新的方法。

Objective To compare the therapeutic effect and complication rate of hypertensive intracerebral hemorrhage(HICH)treated by neuroendoscopy and small bone window craniotomy.Methods Eighty-two patients with HICH from July 2016 to December 2017 were randomly divided into neuroendoscopy group(n=41)and small bone window group(n=41).The intracranial hematomas were cleared by neuroendoscopy and small bone window craniotomy,respectively,and then the operation time,intraoperative blood loss,hematoma clearance rate,and GOS score were compared between the two groups.Results The length of incision,operation time,intraoperative blood loss and operative complications in the neuroendoscopy group were lower than those in the small bone window craniotomy group,but the clearance rate of hematomas was higher than that in the small bone window craniotomy group(P<0.05).Conclusion Neuroendoscopic treatment of HICH has shorter operation time,higher hematomas clearance rate and GOS score than small bone window craniotomy,which provides a new method for minimally invasive treatment of intracranial hemorrhage.