神经内镜与显微镜治疗基底节区高血压脑出血的临床效果比较

Comparison of Clinical Effects of Neuroendoscopy and Microscopy in the Treatment of Hypertensive Cerebral Hemorrhage in the Basal Ganglia Region

目的:比较分析神经内镜经额入路与显微镜经颞入路治疗基底节区高血压脑出血的临床效果。方法:选取2018年11月-2021年11月陕西省榆林市第一医院收治的高血压脑出血患者64例为观察对象,根据手术方式不同分为观察组与对照组,各32例。对照组给予显微镜经颞入路治疗,观察组给予神经内镜经额入路治疗。比较两组患者临床疗效、手术相关指标及格拉斯哥昏迷评分(GCS)。结果:观察组总有效率高于对照组,差异有统计学意义(P<0.05);观察组患者的手术时间、术中出血量及术后入住ICU时间少于对照组,观察组血肿清除率高于对照组,差异有统计学意义(P<0.05);术后7、15、30 d,两组患者GCS评分均持续升高,且同时段观察组均高于对照组,差异有统计学意义(P<0.05)。结论:神经内镜治疗基底节区高血压脑出血可有效提高临床疗效,减少手术时间、术中出血量及术后入住ICU时间,提高血肿清除率及GCS评分。

Objective:To compare and analyze the clinical effects of neuroendoscopic transfrontal approach and microscopic transtemporal approach in the treatment of hypertensive cerebral hemorrhage in the basal ganglia region.Methods:64 patients with hypertensive cerebral hemorrhage admitted to the Yulin First Hospital,Shaanxi Province,from November 2018 to November 2021 were selected as observation subjects.According to the different surgical methods,they were divided into observation group and control group,32 cases each.The control group was treated with microscopic transtemporal approach,and the observation group was treated with neuroendoscopic transtemporal approach.The clinical efficacy,surgery-related indexes and Glasgow Coma Score(GCS)of the two groups were compared.Results:The overall effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).The operating time,intraoperative bleeding and postoperative ICU admission time of patients in the observation group were less than those in the control group,and the hematoma clearance rate of the observation group was higher than that of the control group,with statistically significant differences(P<0.05).At 7,15 and 30 d after surgery,the GCS scores of patients in both groups continued to increase,and the simultaneous periods were higher in the observation group than in the control group,with statistically significant differences(P<0.05).Conclusion:Neuroendoscopic treatment of hypertensive cerebral hemorrhage in the basal ganglia region can effectively improve clinical efficacy,reduce operative time,intraoperative bleeding and postoperative ICU admission time,and improve hematoma clearance rate and GCS score.