组织扩张器辅助神经内镜治疗幕上临界量高血压脑出血的效果

Effect of tissue dilator-assisted neuroendoscopy in the treatment of supratentorially critical hypertensive intracerebral hemorrhage

目的探讨组织扩张器辅助神经内镜治疗幕上临界量高血压脑出血的效果,为幕上临界量高血压脑出血的治疗提供参考。方法回顾性分析三明市第二医院2016年1月~2019年6月收治的45例幕上临界量高血压脑出血患者的临床资料,按照治疗方法的不同分为研究组(22例)和对照组(23例)。研究组采用组织扩张器辅助神经内镜治疗,对照组采用药物保守治疗。比较两组治疗前及治疗后第3、7、14天的格拉斯哥昏迷量表评分(GCS)、治疗期间并发症发生率、住院时间及治疗后3、6个月的格拉斯哥预后评分(GOS)情况。结果两组治疗后第3、7、14天的GCS评分均高于治疗前(P<0.05);研究组治疗后第3、7、14天的GCS评分均高于对照组,差异有统计学意义(P<0.05);研究组的住院时间短于对照组,差异有统计学意义(P<0.05);研究组治疗期间的肺部感染、泌尿系感染发生率低于对照组,差异有统计学意义(P<0.05);两组治疗期间的上消化道出血、下肢深静脉血栓发生率比较,差异无统计学意义(P>0.05);两组治疗后6个月的GOS评分分级情况优于治疗后3个月,差异有统计学意义(P<0.05);研究组治疗后3、6个月的GOS评分分级情况优于对照组,差异有统计学意义(P<0.05)。结论组织扩张器辅助神经内镜治疗幕上临界量高血压脑出血能短期内明显提高患者治疗期间的GCS评分情况,缩短住院时间,降低治疗并发症的发生率,预后较好。

Objective To investigate the effect of tissue dilator-assisted neuroendoscopy in the treatment of supratentorially critical hypertensive intracerebral hemorrhage,and to provide reference for the treatment of supratentorially critical hypertensive intracerebral hemorrhage.Methods The clinical data of 45 patients with supratentorially critical hypertensive intracerebral hemorrhage treated in the Second Hospital of Sanming City from January 2016 to June 2019 were retrospectively analyzed,and they were divided into the study group(22 cases)and the control group(23 cases)according to different treatment methods.The study group was treated with tissue dilator-assisted neuroendoscopy,and the control group was treated with conservative therapy.The Glasgow coma scale(GCS)score before and after treatment at 3,7,14 days,the incidence of complications during treatment,length of stay,and the Glasgow outcome score(GOS)at 3 and 6 months after treatment were compared between the two groups.Results The scores of GCS at 3rd,7th and 14th day after treatment in the two groups were higher than those before treatment(P<0.05).The GCS scores at the 3rd,7th and 14th days after treatment in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).The length of stay of the study group was shorter than that of the control group,the difference was statistically significant(P<0.05).The incidence of lung infection and urinary tract infection during treatment in the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the incidence of upper gastrointestinal bleeding and lower extremity deep vein thrombosis during treatment between the two groups(P>0.05).The scores of GOS between the two groups at 6 months after treatment were higher than that at 3 months after treatment,the difference was statistically significant(P<0.05).The GOS score of the study group at 3,6 months after treatment were better than those of the control group,and the difference was statistically significant(P<0.05).Conclusion Tissue dilator-assisted neuroendoscopy in the treatment of supratentorially critical hypertensive intracerebral hemorrhage can significantly improve GCS scoring during treatment,shorten the hospital stay,reduce the incidence of treatment complications,and have a better prognosis.