神经内镜微创术与小骨窗开颅术治疗高血压基底节区脑出血的效果比较

Comparison of clinical efficacy of minimally invasive surgery with neuroendoscopy and craniotomy with small bone window in the treatment of cerebral hemorrhage in the basal ganglia of hypertension

目的比较高血压基底节区脑出血患者行小骨窗开颅显微术与神经内镜下微创术的治疗效果。方法选择2018年1月—2019年6月就诊于笔者所在医院的80例高血压基底节区脑出血患者作为研究对象,按照治疗方式不同分为两组,各40例。试验组行神经内镜下微创术,对照组行小骨窗开颅显微术。比较两组围术期指标、颅内压、预后及并发症情况。结果与对照组相比,试验组血肿清除率较高、手术用时与住院时间较短、术中失血量较低,差异有统计学意义(P<0.05);试验组颅内压水平为(12.39±1.27)mmHg,低于对照组的(15.37±1.58)mmHg,差异有统计学意义(P<0.05);与对照组相比,试验组预后更佳,术后并发症发生率较低,差异有统计学意义(P<0.05)。结论与小骨窗开颅显微术相比,神经内镜下微创术治疗高血压基底节区脑出血对机体造成的创伤较小,血肿清除率较高,可降低颅内压水平,减少并发症发生,改善预后。

Objective To explore the treatment effect of small bone window craniotomy and neuroendoscopic minimally invasive surgery in patients with hypertensive basal ganglia cerebral hemorrhage.Methods 80 patients who were treated in our hospital from January 2018 to June 2019 were selected.Four patients with hypertensive basal ganglia cerebral hemorrhage were divided into two groups according to different treatment methods,40 cases each.The experimental group was underwent minimally invasive surgery under neuroendoscopy and the control group was underwent craniotomy with small bone windows.Index,intracranial pressure,prognosis and complications were compared.Results Compared to the control group,the hematoma clearance rate was higher in the test group,the duration of surgery and hospitalization was shorter,and the blood loss during the operation was lower.The differences were statistically significant(P<0.05);the intracranial pressure level in the test group was(12.39±1.27)mmHg,which was lower than that in the control group,and the difference was statistically significant(P<0.05);compared to the control group,the prognosis of the test group,the difference was statistically significant(P<0.05);compared to the control group,the incidence of postoperative complications was lower in the experimental group,and the difference was statistically significant(P<0.05).Conclusions Compared to surgery,minimally invasive surgery with neuroendoscopy for the treatment of hypertensive basal ganglia cerebral hemorrhage causes less trauma to the body and a higher hematoma clearance rate.Reduce intracranial pressure levels,reduce complications and improve prognosis.