神经内镜微创手术治疗高血压脑出血的近期效果及远期预后情况分析

Short-Term Effect and Long-Term Prognosis of Neuroendoscopic Minimally Invasive Surgery for Hypertensive Intracerebral Hemorrhage

目的探究神经内镜微创手术治疗高血压脑出血近期效果,并分析远期预后。方法研究时间段为2018年1月至2020年5月,研究对象为118例高血压脑出血患者,结合手术方案划分为对照组和观察组两组,每组59例。对照组实施硬通道微创穿刺引流术,观察组实施神经内镜微创术。记录两组手术前后细胞因子、美国国立卫生院脑卒中量表(NIHSS)评分、Barthel指数的变化,比较两组手术相关指标、并发症情况及术后6个月的预后情况。结果手术时间对比,观察组较长,术中出血量对比,观察组较多,但术后48h、72h时血肿清除率高于对照组,组间比较发现,差异有统计学意义(P<0.05)。手术前后组内比较发现,两组血清P物质(SP)及Barthel指数逐渐上升(P<0.05),肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)及NIHSS评分逐渐下降(P<0.05),术后14d组间比较发现,两组细胞因子、NIHSS评分、Barthel指数差异有统计学意义(P<0.05)。6个月后,观察组的预后良好率为86.44%,高于对照组的71.19%,组间比较发现,差异有统计学意义(P<0.05)。结论高血压脑出血治疗期间,虽说神经内镜微创手术较硬通道微创穿刺引流术操作复杂,但血肿清除更彻底,近期效果及远期预后情况更理想。

Objective To explore the short-term effect of neuroendoscopic minimally invasive surgery in the treatment of hypertensive intracerebral hemorrhage and analyze the long-term prognosis.Methods The study period was from January 2018 to may 2020.118 patients with hypertensive intracerebral hemorrhage were divided into two groups with 59 cases in each group.The control group was treated with hard channel minimally invasive puncture and drainage,and the observation group was treated with neuroendoscopic minimally invasive surgery.The cytokines and National Institutes of Health Stroke Scale Results The operation time of the observation group was longer,the amount of intraoperative bleeding was more,and the observation group was more,but the hematoma clearance rate at 48 h and 72 h was higher than that of the control group(P<0.05)-α(TNF-α),the scores of interleukin-6(IL-6),interleukin-10(IL-10)and NIHSS decreased gradually(P<0.05).On the 14 days after operation,there were significant differences in cytokines,NIHSS score and Barthel index between the two groups(P<0.05)(P<0.05).After 6 months,the good prognosis rate of the observation group was 86.44%,which was higher than 71.19%of the control group.The difference was statistically significant(P<0.05).Conclusion During the treatment of hypertensive intracerebral hemorrhage,although the operation of neuroendoscopic minimally invasive surgery is more complex than that of hard channel minimally invasive puncture and drainage,the hematoma is cleared more thoroughly,and the short-term effect and long-term prognosis are more ideal.