超早期经神经内窥镜治疗基底节区高血压脑出血的临床效果

Clinical study of ultra-early trans-neuroendoscopic treatment of hypertensive cerebral haemorrhage in the basal ganglia region

目的观察早期经神经内窥镜治疗基底节区高血压脑出血的临床效果。方法选取于亳州市人民医院神经外科自2018年1至2019年9月接受超早期(7 h内)经神经内窥镜血肿清除术治疗的45例基底节区高血压脑出血患者为研究组,并选取同期与研究组基线资料相匹配的于脑出血7~24 h内接受经神经内窥镜血肿清除术治疗的44例患者为对照组。比较2组患者术后再出血率、血肿清除率、并发症发生率以及GCS、NIHSS、Barthel评分。结果研究组和对照组的再出血率、血肿清除率及并发症发生率比较,差异无统计学意义(P>0.05);研究组术后3、7 d的GCS、Barthel评分高于对照组,NIHSS评分低于对照组,差异均具有统计学意义(P<0.05)。结论相比于脑出血后7~24 h进行手术,在脑出血7 h内进行神经内窥镜血肿清除术对于患者术后神经受损及生活质量的改善作用更为显著。

Objective To observe the clinical effect of early treatment of hypertensive intracerebral hemorrhage in basal ganglia area by neuroendoscope.Methods Forty-five patients with hypertensive intracerebral hemorrhage in the basal ganglia region who received ultra early(within 7 h)neuroendoscopic hematoma removal in Neurosurgery Department of Bozhou People’s Hospital from January 2018 to September 2019 were selected as the study group.At the same time,44 patients who received neuroendoscopic hematoma removal within 7-24 h of intracerebral hemorrhage matched with the baseline data of the study group were selected as the control group.The postoperative rebleeding rate,hematoma clearance rate,complication rate,GCS,NIHSS and Barthel scores were compared between the control group and the study group.Results There was no significant difference in rebleeding rate,hematoma clearance rate,intracranial hematoma,intracranial infection and pulmonary infection between two groups(P>0.05).The GCS and Barthel scores of the study group at 3 and 7 d afteroperation were higher than those of the control group(P<0.05);NIHSS scores in the study group at 3 and 7 d after operation was lower than that in the control group(P<0.05).Conclusion Compared with surgery 7-24 h after intracerebral hemorrhage,neuroendoscopic surgery within 7 h after intracerebral hemorrhage has a more significant effect on the improvement of postoperative nerve damage and quality of life.