不同入路途径神经内镜治疗方案对高血压性脑出血患者神经功能及并发症的影响

Effects of endoscopic surgery vvia different approaches on neurological function and complications in patients with hypertensive cerebral hemorrhage

目的:研究不同入路途径神经内镜治疗方案对高血压性脑出血患者神经功能及并发症的影响。方法:选取本院神经外科诊治的高血压性脑出血患者72例为研究对象,根据不同入路途经分为研究组(n=37)与对照组(n=35),研究组为外侧裂入路,对照组为冠状缝前入路。观察两组疗效、血肿清除、术后苏醒时间、术后脑水肿、日常生活能力、神经功能、并发症。结果:研究组疗效高于对照组,差异有统计学意义(P<0.05);研究组术后脑水肿、术后苏醒时间、术后颅内压均小于对照组,且血肿清除率高于对照组,差异有统计学意义(P<0.05);治疗后3、6个月,研究组日常生活能力高于对照组,神经功能障碍低于对照组(P<0.05);研究组并发症率低于对照组(P<0.05);两组病死率比较,差异无统计学意义(P>0.05)。结论:不同入路途径治疗高血压性脑出血患者有不同疗效,外侧裂入路与冠状缝前入路比较,神经功能损害较小,且术后并发症率较少。

Objective:To investigate the effects of endoscopic surgery via different approaches on neurological function and complications in patients with hypertensive cerebral hemorrhage.Methods:A total of 72 patients with hypertensive intracerebral hemorrhage underwent endoscopic surgery in our hospital from March 2016 to March 2019 were enrolled,and were divided into two groups according to the different approaches.The study group(n=37)adopted the lateral fissure approach,and the control group(n=35)adopted the coronal suture anterior approach.The curative effect,hematoma clearance,intracranial pressure,postoperative recovery time,postoperative brain edema,daily living ability,neurological function and complications were observed.Results:The efficacy rate of the study group was higher than that of the control group(P<0.05);The postoperative cerebral edema,postoperative recovery time and postoperative intracranial pressure were lower in the study group than in the control group,and the hematoma clearance rate was higher than that in the control group(P<0.05).At 3 and 6 months after treatment,the daily living ability of the study group was higher than that of the control group,and the neurological dysfunction was lower than that of the control group(P<0.05).The complication rate of the study group was lower than that of the control group(P<0.05).There was no significant difference in mortality rate between the two groups(P>0.05).Conclusion:Different surgery approaches have different clinical efficacy.Compared with the coronal suture anterior approach,lateral fissure approach has less neurological damage and less postoperative complications for patients with hypertensive intracerebral hemorrhage underwent endoscopic surgery.