神经内镜治疗基底节区高血压脑出血的效果

Curative effect of neuroendoscopy on hypertensive intracerebral hemorrhage in basal ganglia

目的:研究基底节区高血压脑出血使用神经内镜的治疗效果。方法:选择2016年1月至2018年12月江苏省张家港市第一人民医院收治的基底节区高血压脑出血患者50例,依据治疗方法不同分为观察组和对照组,各25例。观察组行神经内镜血肿清除术,对照组行开颅血肿清除术。观察2组基本手术指标与血肿清除情况,统计并发症发生情况与病死率,量表评价2组治疗前后神经功能缺损情况及生活能力等。结果:观察组术后残余量及血肿清除率均优于对照组(P<0.05)。观察组手术时间,麻醉时间,术中出血量,入住ICU时间和住院时间均低于对照组(P<0.05),术后并发症发生率低于对照组(P<0.05)。术后6个月,观察组日常生活能力量表(activities of daily living,ADL)、功能独立性测量(functional independence measure,FIM)和美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分均优于对照组(P<0.05)。结论:基底节区高血压脑出血使用神经内镜治疗血肿清除率较高,术后恢复快、并发症发生率相对较低,神经功能、日常生活能力等恢复好,微创性手术优势明显。

Objective:To study the curative effect of neuroendoscopy on hypertensive intracerebral hemorrhage(HICH)in basal ganglia.Methods:From January 2016 to December 2018,50 patients with HICH in basal ganglia who were admitted to Zhangjiagang First People’s Hospital were selected.According to the treatment methods,they were divided into an observation group and a control group,each of 25 cases.The observation group used endoscopic hematoma clearance,and the control group used craniotomy hematoma clearance.Basic operation indexes and hematoma clearance,complications and mortality rate of the two groups were observed.The neurological deficit and life ability of the two groups before and after treatment were evaluated by the scales.Results:Postoperative residual volume and hematoma clearance rate of the observation group were better than those of the control group(P<0.05).Operation time,anesthesia time,intraoperative blood loss,ICU stay time,and hospitalization time were lower than those of the control group(P<0.05).The incidence of post-operative complications was lower than that of the control group(P<0.05),and the observation group scored better than the control group on the activities of daily living(ADL),functional independence measure(FIM),National Institute of Health stroke scale(NIHSS)scale 6 months after the operation(P<0.05).Conclusion:HICH in the basal ganglia area is better treated with neuroendoscopy,with higher hematoma clearance rate,fast postoperative recovery,relatively lower incidence of complications and good recovery of nerve function and daily living ability.The advantages of minimally invasive surgery are obvious.