神经内镜与显微手术治疗基底节脑出血的疗效分析

Efficacy analysis of neuroendoscopy and microsurgery on basal ganglia cerebral hemorrhage

目的研究神经内镜与显微手术治疗基底节脑出血的疗效。方法回顾性分析2019年1月至2021年10月该院神经外科收治的116例基底节脑出血患者临床资料,根据手术方式分为内镜组(51例)和显微手术组(65例)。内镜组采用神经内镜下血肿清除术,显微手术组采用常规翼点开颅小骨窗血肿清除术,比较两组手术疗效、血肿清除率、术前美国国立卫生研究院卒中量表评分(NIHSS)、术前术后1周格拉斯哥昏迷评分(GCS)、术后脑水肿、术后并发症及术后3个月格拉斯哥预后评分(GOS)。结果内镜组手术时间、术中失血量、术后第1天脑水肿、术后1周GCS均优于显微手术组,差异有统计学意义(P<0.05);两组血肿清除率、术后并发症发生情况比较,差异无统计学意义(P>0.05);两组术后3个月GOS比较,差异有统计学意义(P<0.05)。结论神经内镜治疗基底节脑出血疗效优于显微手术,可改善患者预后。

Objective To study the efficacy of neuroendoscopy and microsurgery in the treatment of basal ganglia cerebral hemorrhage.Methods The clinical data of 116 patients with basal ganglia hemorrhage admitted to department of neurosurgery of the hospital from January 2019 to October 2021 were retrospectively analyzed.The patients were divided into the endoscopic group(51 cases)and the microsurgery group(65 cases).Neuroendoscope hematoma removal was performed in the endoscopic group,and conventional pterygeal point craniotomy small bone window hematoma removal was performed in the microsurgery group.The surgical efficacy,clearance of hematoma,preoperative National Institutes of Health Stroke Scale score(NIHSS),preoperative Glasgow Coma Score(GCS)a week after operation,postoperative brain edema,postoperative complications and postoperative three months Glasgow outcome scale(GOS)were compared between the two groups.Results The endoscopic group was better than the microsurgery group in terms of operation time,intraoperative blood loss,postoperative brain edema on the first day,and GCS one week after surgery,and the differences were statistically significant(P<0.05).There was no significant difference in hematoma clearance and postoperative complications between the two groups(P>0.05).There was significant difference in GOS between the two groups at three months after operation(P<0.05).Conclusion Neuroendoscopic treatment of basal ganglia cerebral hemorrhage is more effective than microsurgery,it improved prognosis.