内镜下颅内血肿清除术与开颅血肿清除术治疗高血压脑出血的效果比较

Comparison of the effects of endoscopic intracranial hematoma removal and craniotomy in the treatment of hypertensive cerebral hemorrhage

目的探讨内镜下颅内血肿清除术与开颅血肿清除术治疗高血压脑出血的效果比较情况。方法回顾性选取2018年2月至2020年2月九江市第一人民医院收治的60例高血压脑出血患者作为研究对象,按照不同治疗方式分为治疗A组和治疗B组,每组各30例。治疗A组采用内镜下颅内血肿清除术,治疗B组采用开颅血肿清除术,比较两组患者手术时间、术中出血量、术后3周格拉斯哥昏迷指数(GCS)评分、术后6个月日常生活能力评分情况及术后并发症总发生率。结果治疗A组手术时间短于治疗B组,术中出血量少于治疗B组,术后3周GCS评分优于治疗B组,术后6个月日常生活能力预后良好率高于治疗B组,术后并发症总发生率低于治疗B组,差异有统计学意义(P<0.05)。结论内镜下颅内血肿清除术治疗高血压脑出血患者创伤小,预后良好,并发症少,值得临床推广应用。

Objective To explore the comparison of the effects of endoscopic intracranial hematoma removal and craniotomy in the treatment of hypertensive cerebral hemorrhage.Methods A total of 60 patients with hypertensive intracerebral hemorrhage admitted to Jiu Jiang No.1 People′s Hospital from February 2018 to February 2020 were retrospectively selected as the research subjects.According to different treatment methods,they were divided into treatment group A and treatment group B,with 30 patients in each group.The treatment group A was treated with endoscopic intracranial hematoma removal,and the treatment group B was treated with craniotomy removal.The operation time and intraoperative blood loss of the two groups were observed,and the Glasgow coma scale(GCS)score was observed 3 weeks after operation.The score of daily living ability and total incidence of postoperative complications were also observed in the 6 months after operation.Results The operation time of the treatment group A was shorter than that in the treatment group B,and the intraoperative blood loss was less than that in the treatment group B,the GCS score was better than that in the treatment group B three weeks after treatment,the prognostic good rate was higher than that of the treatment group B,and the total incidence of postoperative complications was lower than that of the treatment group B six months after treatment,and the differences were statistically significant(P<0.05).Conclusion Endoscopic intracranial hematoma removal for patients with hypertensive cerebral hemorrhage has mild trauma,good prognosis and few complications,and it is worthy of clinical application.