CT定位辅助神经内镜手术与立体定向血肿清除术治疗高血压脑出血临床疗效观察

CT-guided neuroendoscopic invasive surgery and stereotactic hematoma clearance in the treatment of hypertensive cerebral hemorrhage

目的:分析CT定位辅助神经内镜手术与立体定向血肿清除术治疗高血压脑出血的疗效和安全性。方法:回顾性分析60例高血压脑出血患者的临床资料。采用CT定位辅助神经内镜手术者设为实验组,采用立体定向血肿清除术者为对照组。比较两组的基本情况、临床疗效、预后、神经功能和炎症因子,并观察术后并发症发生情况。结果:与对照组比较,实验组手术时间明显缩短,差异有统计学意义(P<0.05)。实验组血肿清除率和术中出血量明显优于对照组(P<0.05)。术后4周实验组出血量、血肿周围水肿、NIHSS评分、血清hs-CRP水平显著低于对照组(P<0.05)。6个月后观察远期疗效,实验组ADL评分显著高于对照组(P<0.05)。结论:与立体定向血肿清除术相比,CT定位辅助神经内镜手术治疗高血压脑出血更有效,有利于恢复神经功能,改善预后,降低血清炎症因子水平,且并发症少。

Objective:To compare the efficacy and safety of CT-guided neuroendoscopic invasive surgery and stereotactic hematoma clearance in the treatment of hypertensive cerebral hemorrhage.Methods:The clinical data of 60 patients with hypertensive intracerebral hemorrhage were analyzed retrospectively.Patients were randomly divided into two groups:an observation group(Group A)and a control group(Group B).Group A underwent CT-guided neuroendoscopic invasive surgery,while Group B was treated with stereotactic hematoma clearance.The basic situation,clinical efficacy,prognosis,neurological function and the changes in serum inflammatory factors of the two groups were compared,and the postoperative complications were observed.Results:The operation time was significantly shortened in Group A to compare with that in Group B,with statistical significance(P<0.05).The hematoma clearance rate and intraoperative bleeding volume in Group A were significantly better than those in Group B,with statistical significance(P<0.05).After 4 weeks,NIHSS score,hs-CRP levels,hematoma and perihematomal edema volumes in Group A after treatment were significantly lower than those before treatment and those in Group B after treatment(P<0.05).After 6 months,The ADL score of Group A were significantly higher than those of Group B(P<0.05).Conclusion:CT-guided neuroendoscopic invasive surgery for hypertensive cerebral hemorrhage was more effective than stereotactic hematoma clearance.It is conducive to the recovery of neurological function,improving prognosis,reducing the level of serum inflammatory factors and fewer complications.