导航辅助神经内镜硬通道微创治疗基底节区高血压脑出血的疗效及安全性分析

Efficacy and safety of navigation-assisted neuroendoscopic hard channel minimally invasive surgery in the treatment hypertensive intracerebral hemorrhage in basal ganglia

目的:探讨导航辅助神经内镜硬通道微创治疗基底节区高血压脑出血(HICH)的疗效及安全性。方法:回顾性分析行导航辅助神经内镜硬通道微创治疗的42例患者(观察组)和行小骨窗开颅血肿清除术的38例患者(对照组)的资料,观察两组患者手术恢复相关指标、治疗效果、神经缺损功能恢复情况、预后、血清生化指标和术后并发症。结果:观察组住院时间短于对照组(P<0.05),血肿清除率高于对照组(P<0.05),残留血肿量少于对照组(P<0.05);术后7 d,两组患者美国国立卫生研究院卒中量表(NIHSS)评分、格拉斯哥昏迷量表(GCS)较术前有改善,两组患者血清血管生成素-1(Ang-1)、内皮素(ET)、血管升压素(AVP)水平较术前均下降(P<0.05),组间比较,差异具有统计学意义(P<0.05);观察组术后并发症总发生率低于对照组(P<0.05)。结论:与小骨窗开颅血肿清除术相比,导航辅助神经内镜硬通道微创能促进HICH患者康复出院,提高血肿清除效果,减少残留血肿量,改善神经缺损功能和预后,术后并发症低,可在临床上推广应用。

Objective:To explore the efficacy and safety of navigation-assisted neuroendoscopic hard channel minimally invasive surgery in the treatment of hypertensive intracerebral hemorrhage(HICH)in basal ganglia.Methods:The data of 42 patients with navigation-assisted neuroendoscopic hard channel minimally invasive treatment(observation group)and 38 patients undergoing small bone window craniotomy for hematoma removal(control group)were retrospectively analyzed.The surgical recovery-related indicators,treatment effect,recovery of neurological deficit,prognosis,serum biochemical indicators and postoperative complications were observed in both groups.Results:The hospital stay in observation group was shorter than that in control group(P<0.05),and the hematoma clearance rate was higher(P<0.05),and the residual hematoma volume was less than that in control group(P<0.05).At 7 days after surgery,the score of National Institutes of Health Stroke Scale(NIHSS)and score of Glasgow Coma Scale(GCS)of the two groups were improved compared with those before surgery while the levels of serum angiopoietin-1(Ang-1),endothelin(ET)and arginine vasopressor(AVP)were reduced compared with those before surgery(P<0.05),and there were significant differences between groups(P<0.05).The total incidence rate of postoperative complications in observation group was lower than that in control group(P<0.05).Conclusion:Compared with small bone window craniotomy for hematoma removal,navigation-assisted neuroendoscopic hard channel minimally invasive surgery can better promote the fast rehabilitation and discharge,enhance the hematoma removal effect,reduce the residual hematoma volume and improve the neurological deficit and prognosis of patients with HICH,and it has fewer complications,thus this method can be used in clinical practice.