软性神经内镜辅助治疗慢性硬膜下血肿的效果及安全性分析

Effect and Safety Analysis of Soft Neuroendoscopy in the Treatment of Chronic Subdural Hematoma(CSDH)

目的研究软性神经内镜辅助治疗慢性硬膜下血肿的效果及安全性。方法某院2017年2月1日-2019年2月28日收治的慢性硬膜下血肿患者94例,将其按照随机数表法等分成内镜组和对照组每组各47例。对照组实施颅骨钻孔引流术治疗,内镜组则实施软性神经内镜辅助治疗。比较2组临床疗效,术后并发症情况,手术前后血清神经功能指标水平,手术前后日常生活活动能力等。结果内镜组治疗总有效率97.87%,显著高于对照组的80.85%(P<0.05)。内镜组并发症总发生率48.94%,显著低于对照组的82.98%(P<0.05)。内镜组术后1天血清神经元特异性烯醇化酶、神经生长因子水平均显著低于对照组(均P<0.05)。内镜组及对照组术后30天的日常生活活动能力量表评分均明显高于术前1天,且内镜组显著高于对照组(均P<0.05)。结论软性神经内镜辅助治疗慢性硬膜下血肿的效果显著,且安全性较好,有利于患者神经功能以及日常生活活动能力的恢复,值得临床推广应用。

Objective To study the effect and safety of soft neuroendoscopy in the treatment of chronic subdural hematoma(CSDH).Methods 94 patients with CSDH admitted to our hospital from February 2017 to February 2019 were included in the study.They were divided into endoscopy group and control group according to the random number table.Each group was 47.The control group was treated with cranial drainage,while the endoscopic group was treated with soft neuroendoscopy.The two groups were compared in clinical efficacy,postoperative complications,serum neurological function index before and after surgery,and daily life activity before and after surgery.Results The total effective rate of endoscopic group was significantly higher than that of control group(P<0.05).The overall incidence of complications in the endoscopic group was significantly lower than that in the control group(P<0.05).Serum NSE and NGF levels in the endoscopic group were significantly lower than those in the control group one day after surgery(all P<0.05).The ADL score of the endoscopic group and the control group was significantly higher than that of the preoperative group on the first day after 30 days of surgery,and that of the endoscopic group was significantly higher than that of the control group(all P<0.05).Conclusions Soft neuroendoscopy assisted treatment of CSDH had a significant effect and a good safety,which was conducive to the recovery of patients’neurological function and daily life activity.It was worthy of clinical application.