神经内镜下经外侧裂入路联合即溶止血纱治疗基底节脑出血的临床研究

Clinical Study of Neuroendoscopy Via Lateral Fissure Approach Plus Hemostatic Gauze on Treatment of Basal Ganglia Hemorrhage

目的探析神经内镜下经外侧裂入路联合即溶止血纱治疗基底节脑出血的临床效果。方法选取2017年7月至2018年6月广西医科大学附属武鸣医院收治的120例基底节区脑出血患者作为研究对象,依据随机数字表法分为研究组和对照组,各60例。研究组采用神经内镜下经外侧裂入路联合即溶止血纱方法治疗,对照组采用单独进行内镜下清除脑内血肿方法治疗,对两组病例的临床疗效、住院时间、治疗费用、神经功能以及日常生活能力等进行临床验证。结果对照组与研究组血肿残留5%以内分别占比85.00%、96.67%,组间比较差异有统计学意义(P<0.05);研究组二次出血发生率低于对照组,组间比较差异有统计学意义(P<0.05)。两组患者时间指标、费用相比,研究组时间均较短,费用较低,差异有统计学意义(P<0.05)。两组术前ADL及NFDS评分相比,差异无统计学意义(P>0.05);术后1年评分相比,研究组NFDS评分降低(P<0.05),ADL评分升高(P<0.05)。结论采用神经内镜下经外侧裂入路联合即溶止血纱治疗基底节脑出血的疗效明显,止血效果好,血肿清除率高,能最大限度地保护外侧裂周围的脑组织功能,降低致残率及致死率。

Objective To discuss the clinical effect of neuroendoscopy via lateral fissure approach plus hemostatic gauze on treatment of basal ganglia hemorrhage.Methods A total of 120 patients with basal ganglia intracerebral hemorrhage from July 2017 to June 2018 in Wuming Hospital Affiliated to Guangxi Medical University were selected as the subjects.According to the difference of treatment methods,60 patients were included in the study group,and 60 patients were included in the control group.Results Within 5%of the residual hematoma in the control group and the study group The proportion was 85.00%and 96.67%,the difference between the two groups was statistically significant(P<0.05),and the incidence of secondary bleeding in the two groups was lower than that in the study group(P<0.05).Compared with the two groups of time index and cost,the and lower cost,and the difference was statistically significant(P<0.05).There was no significant difference in preoperative ADL and NFDS score between the two groups(P>0.05),and the NFDS score of the study group decreased(P<0.05)and the ADL score increased(P<0.05).Conclusion The neuroendoscopy via lateral fissure approach combined with hemostatic gauze has obvious effects on treatment of basal ganglia hemorrhage,which can protect the brain tissue function around the lateral fissure,reduce the disability and fatality rate,increase the life quality,hemostatic effects and hematoma clearance rate,and simply the operation procedures.