神经内镜手术与传统开颅术治疗高血压基底节区脑出血的疗效对比分析

Comparison and analysis of the efficacy of neuroendoscopic surgery and traditional craniotomy in the treatment of hypertensive basal ganglia cerebral hemorrhage

目的探讨神经内镜下手术与传统开颅术治疗高血压基底节区脑出血的效果。方法选取42例就诊于徐州医科大学附属医院的高血压基底节区脑出血患者,按手术方式不同分为内镜组(21例)和开颅组(21例),内镜组患者采用内镜下血肿清除术,开颅组采用传统大骨瓣开颅血肿清除术。比较2组患者血肿清除率、手术时间、术中出血量、术后再出血率、并发症发生率、术后2周脑水肿情况、住院时间及术后3个月格拉斯哥预后评分(GOS)。结果内镜组在血肿清除率、手术时间、术中出血量、术后2周脑水肿情况、住院时间及术后3个月GOS方面优于开颅组,差异有统计学意义(P<0.05);2组患者术后再出血率和并发症发生率比较,差异无统计学意义(P>0.05)。结论与传统开颅血肿清除术比较,神经内镜应用于高血压基底节区脑出血的手术治疗中更具优势,可提高血肿清除率,缩短手术时间,减少术中出血,减轻术后脑水肿,缩短住院时间,改善患者预后。

Objective To discuss the therapeutic effect of neuroendoscopic surgery and traditional craniotomy in the treatment of hypertensive basal ganglia cerebral hemorrhage.Methods Totally 42 patients with hypertensive basal ganglia hemorrhage who were admitted into the affiliated hospital of Xuzhou Medical University were selected and randomly divided into the endoscopic group(21 cases)and the craniotomy group(21 cases).Patients in the endoscopic group were treated with endoscopic hematoma removal surgery,while patients in the craniotomy group were treated with traditional craniotomy evacuation of hematoma.The hematoma clearance rate,operative time,intraoperative blood loss,postoperative rebleeding rate,complication rate,cerebral edema 2 weeks after surgery,length of hospital stay and Glasgow outcome score(GOS)3 months after surgery were compared between the two groups.Results The hematoma clearance rate,operative time,intraoperative blood loss,cerebral edema 2 weeks after surgery,length of hospital stay and GOS 3 months after surgery in the endoscopic group were better than those in the craniotomy group,and the differences were statistically significant(P<0.05).And there was no statistically significant difference between the two groups in terms of postoperative rebleeding rate and complication rate(P>0.05).Conclusion The application of neuroendoscopic surgery for the treatment of hypertensive basal ganglia cerebral hemorrhage is more advantageous than the traditional craniotomy,which can improve the hematoma clearance rate,shorten the operation time,reduce the intraoperative bleeding,reduce postoperative cerebral edema,shorten hospitalization time and improve the prognosis of patients.