神经内镜微创术对高血压性脑出血患者血肿清除率及神经功能的影响

Effect of neuroendoscopic microtrauma on hematoma clearance rate and neurological function in patients with hypertensive cerebral hemorrhage

目的探讨神经内镜微创术对高血压性脑出血患者血肿清除率及神经功能的影响。方法回顾性分析瓦房店中心医院2018年3月~2020年2月收治的40例高血压性脑出血患者临床资料,根据其手术治疗方式分为对照组(17例)与观察组(23例)。对照组行开颅微创血肿清除术治疗,观察组行神经内镜微创术治疗,比较两组血肿清除率、应激反应、神经功能及并发症总发生率。结果观察组血肿清除率高于对照组、并发症总发生率低于对照组,差异有统计学意义(P<0.05);两组术前神经功能、氧化应激指标水平比较,差异无统计学意义(P>0.05);术后24 h,观察组内皮素(ET)、皮质醇(Cor)水平低于对照组,差异有统计学意义(P<0.05);术后6个月,观察组临床神经功能缺损评分(CSS)均低于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论高血压性脑出血患者行神经内镜微创术治疗可提高血肿清除率,降低应激反应,改善神经功能,且安全性高。

Objective To explore the effect of neuroendoscopic microtrauma(NM)on hematoma clearance rate(HCR)and neurological function(NF)in patients with hypertensive cerebral hemorrhage(HCH).Methods A total of 40 patients with HCH admitted to Wafangdian Central Hospital from March 2018 to February 2020 were retrospectively collected and divided into the control group(n=17)and the observation group(n=23)according to different surgical treatments.The control group were treated with craniotomy minimally invasive hematoma removal and the observation group were treated with NM.HCR,stress response,score of NF,and the incidence of complications were compared between the two groups.Results HCR in the observation group was higher than in the control group,and the total incidence of complications was lower than that of the control group,the differences were statistically significant(P<0.05).There were no statistical significance in the preoperative NF score or oxidative stress between the two groups(P>0.05).The levels of endothelin(ET)and cortisol(Cor)24 hours after operation in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Six months after operation,the Chinese stroke scale(CSS)score of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion NM for patients with HCH can improve HCR,reduce stress response and improve NF,with high safety.