神经内镜下脑出血清除术联合置管引流治疗急性脑出血脑室破入患者的临床效果分析

Clinical Effect Analysis of the Treatment of Acute Intracerebral Hemorrhage with Intraventricular Puncture by Neuroendoscope Combined with Catheter Drainage

目的探讨神经内镜下脑出血清除术联合置管引流治疗急性脑出血脑室破入患者的临床效果分析。方法选取2020年1月至2022年12月收治的80例急性脑出血脑室破入患者作为研究对象,用随机数字表法将其分为对照组和观察组,各40例。对照组接受显微镜下脑实质血肿清除术+脑室钻孔引流术治疗,观察组接受神经内镜下脑出血清除术联合置管引流术治疗。比较两组患者血肿清除率、miRNA-155、胱抑素C(Cys-C)、血清神经元特异性烯醇化酶(NSE)、并发症发生率等。结果观察组术后1 d、3 d、7 d时,脑室血肿清除率高于对照组(P<0.05),比较脑实质血肿清除率,组间无差异(P>0.05);两组术前miRNA-155、Cys-C、NSE指标比较结果为无差异(P>0.05);术后1周时,观察组miRNA-155、Cys-C、NSE指标低于对照组(P<0.05);观察组并发症发生率7.50%低于对照组10.00%,但组间无差异(P>0.05)。结论临床治疗急性脑出血脑室破入可采用神经内镜下脑出血清除术联合置管引流,手术不会加大患者机体NSE、Cys-C、miRNA-155等指标,对控制炎性反应非常有利,并可提升血肿清除率,且无须过度担忧手术安全性。

Objective To explore the clinical effect of endoscopic intracerebral hemorrhage clearance combined with catheter drainage in the treatment of patients with acute intracerebral hemorrhage with ventricular rupture.Methods Eighty patients with acute intracerebral hemorrhage and ventricular rupture admitted from January 2020 to December 2022 were selected as the study subjects.They were divided into control group and observation group by random number table method,with 40 patients in each group.The control group received microscopic parenchymal hematoma removal+ventricular drilling and drainage,and the observation group received neuroendoscopic cerebral hemorrhage removal combined with catheter drainage.The clearance rate of hematoma,miRNA-155,cystatin C(Cys-C),serum neuron-specific enolase(NSE),and complication rate were compared between the two groups.Results The clearance rate of ventricular hematoma in the observation group was higher than that in the control group on the 1st,3rd and 7th day after operation(P<0.05).The clearance rate of hematoma in brain parenchyma was compared,there was no difference between groups(P<0.05);the comparison results of preoperative miRNA-155,Cys-C and NSE between the two groups were no idfference(P>0.05).At the first week after operation,the miRNA-155,Cys-C and NSE indexes in the observation group were lower than those in the control group(P<0.05);The incidence of complications in the observation group was 7.50%lower than that in the control group 10.00%,but there was no difference between group(P>0.05).Conclusion In clinical treatment of acute intracerebral hemorrhage,intraventricular puncture can be treated with neuroendoscopic intracerebral hemorrhage clearance combined with catheter drainage.The operation will not increase the NSE,Cys-C,miRNA-155 and other indicators of the patient's body,which is very beneficial to control inflammatory reaction,and can improve the hematoma clearance rate,and there is no need to worry too much about the operation safety.