经额锁孔血肿清除术治疗脑室出血的临床效果及术后脑积水发生率分析

Clinical Effect of Transfrontal Keyhole Hematoma Removal in the Treatment of Ventricular Hemorrhage and Analysis of the Incidence of Postoperative Hydrocephalus

目的:探究对脑室出血患者施行经额锁孔血肿清除术治疗的效果及对术后脑积水发生率的影响。方法:借助信封随机法将2018年5月-2019年12月本院78例脑室出血患者分为对照组(39例,施行钻颅脑室外引流术治疗)、观察组(39例,施行经额锁孔血肿清除术治疗)。随访3个月,对比两组术中出血量、引流管留置时间、住院时间、炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]水平、并发症发生率、预后评分及术后脑积水发生率。结果:观察组引流管留置时间、住院时间均较对照组更短,术中出血量多于对照组(P<0.05)。随访3个月发现,观察组预后评分较对照组更高(P<0.05);观察组术后3 d及术后1周CRP、TNF-α水平均较对照组更低(P<0.05);观察组并发症发生率(17.95%)及术后脑积水发生率(10.26%)均较对照组(38.46%、33.33%)更低,差异有统计学意义(P<0.05)。结论:对脑室出血患者施行经额锁孔血肿清除术治疗更有助于缩短引流时间,且术后脑积水发生率更低。

Objective:To explore the effect of transfrontal keyhole hematoma removal in patients with ventricular hemorrhage and its influence on the incidence of postoperative hydrocephalus.Method:A total of 78 patients with ventricular hemorrhage in our hospital from May 2018 to December 2019 were divided into the control group(39 cases,underwent external ventricular drainage)and the observation group(39 cases,underwent transfrontal keyhole hematoma removal)by envelope randomization method.Followed up for 3 months,the intraoperative blood loss,drainage tube indwelling time,hospital stay,inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)]levels,complication rate,prognosis score and the incidence of postoperative hydrocephalus were compared between two groups.Result:The drainage tube indwelling time and hospital stay in the observation group were shorter than those in the control group,the amount of intraoperative blood loss was more than that in the control group(P<0.05).After 3 months of follow-up,the prognosis score of the observation group was higher than that of the control group(P<0.05);the levels of CRP and TNF-αin the observation group were lower than those in the control group at 3 d and 1 week after surgery(P<0.05);the incidence of complications in the observation group(17.95%)and the incidence of postoperative hydrocephalus(10.26%)were lower than the control group(38.46%,33.33%),the differences were statistically significant(P<0.05).Conclusion:Transfrontal keyhole hematoma removal for patients with ventricular hemorrhage is more helpful to shorten the drainage time,and the incidence of postoperative hydrocephalus is lower.