神经内镜手术治疗高血压脑出血早期脑疝患者的效果分析

Analysis of Curative Effect of Neuroendoscopic Surgery in Patients with Early Cerebral Hernia with Hypertensive Cerebral Hemorrhage

目的:观察神经内镜手术治疗高血压脑出血早期脑疝患者的效果。方法:选取2019年1月-2020年10月本院收治的63例高血压脑出血早期脑疝患者,根据手术方式不同分为对照组(n=45)和研究组(n=18)。对照组采用开颅去大骨瓣手术,研究组采用神经内镜手术。比较两组术后再出血发生率、血肿清除程度、手术时间、平均住院的时间、术中出血量及预后效果。结果:两组术后再出血发生率和血肿清除率比较,差异均无统计学意义(P>0.05)。研究组手术时间、平均住院时间均短于对照组,术中失血量少于对照组,差异均有统计学意义(P<0.05)。研究组预后效果优于对照组,差异有统计学意义(P<0.05)。结论:高血压脑出血早期脑疝采取神经内镜手术治疗效果较好,血肿清除程度高,能改善预后效果,减少患者手术和住院的时间,降低术后出血量以及致残、死亡的风险,应推广应用。

Objective:To observe the effect of neuroendoscopic surgery in patients with early cerebral hernia with hypertensive cerebral hemorrhage.Method:A total of 63 patients with early cerebral hernia with hypertensive cerebral hemorrhage admitted to our hospital from January 2019 to October 2020 were selected,and they were divided into control group (n=45) and study group (n=18) according to different surgical methods.The control group was treated with craniotomy to remove large bone flap,and the study group was treated with neuroendoscopic surgery.The incidence of postoperative rebleeding,degree of hematoma clearance,surgical time,average length of hospital stay,intraoperative blood loss and prognosis were compared between two groups.Result:There were no significant differences in the incidence of postoperative rebleeding and hematoma clearance rate between two groups (P>0.05).The surgical time,average length of hospital stay of the study group were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group,the differences were statistically significant (P<0.05).The prognosis of the study group was superior than that of the control group,the difference was statistically significant (P<0.05).Conclusion:Neuroendoscopic surgery is effective in the early cerebral hernia with hypertensive cerebral hemorrhage,which can improve the degree of hematoma clearance and improve the prognosis,reduce the surgical time and the average length of hospital stay,reduce the amount of bleeding after operation and the risk of disability and death of patients.which should be widely used.