软通道血肿穿刺引流术与神经内镜颅内血肿清除术治疗高血压脑出血的疗效

Comparative analysis of soft channel puncture drainage and neural endoscopic intracranial hematoma evacuation in the treatment of hypertensive cerebral hemorrhage

目的评价软通道血肿穿刺引流术(soft channel puncture drainage,SCPD)与神经内镜颅内血肿清除术(neural endoscopic intracranial hematoma evacuation,NEIHE)治疗高血压脑出血的临床疗效及安全性差异。方法回顾性收集2020年1月至2021年12月宁夏医科大学总医院NCU收治的分别接受SCPD和NEIHE治疗的高血压脑出血患者共110例(SCPD组53例,NEIHE组57例),比较两组患者的手术时间、术中出血量、72 h血肿清除率、术后并发症及功能恢复、住院时长、花费等相关指标。结果与NEIHE组相比,SCPD组手术时间短[(1.13±0.41)h vs.(1.78±0.31)h],术中出血量少[(10.83±3.95)mL vs.(70.62±43.12)mL],花费低[(66135.01±33178.64)元vs.(95834.93±42784.48)元],但NEIHE组比SCPD组72 h血肿清除率高(86.87%vs.74.4%),差异有统计学意义(P<0.05);而两组在术后并发症、功能恢复、总住院时间等方面比较差异均无统计学意义(P>0.05)。结论SCPD和NEIHE均操作简单,且能有效清除颅内血肿,改善神经功能,但SCPD手术时间更短,术中出血量更少,而且适合不能耐受全麻手术的患者,而NEIHE则血肿清除更为彻底,二者在改善功能预后及总体住院时间等方面无明显差异。

Objective To evaluate the clinical efficacy and safety difference between soft channel hemato⁃ma puncture drainage(SCPD)and neural endoscopic intracranial hematoma evacuation(NEIHE)in the treatment of hypertensive cerebral hemorrhage.Methods We collected the patients who received SCPD and NEIHE in the neurological intensive care unit of General Hospital Of Ningxia Medical University from January 2020 to December 2021.A total of 110 patients with hypertensive intracerebral hemorrhage were treated with two different groups(53 cases in the SCPD group and 57 cases in the NEIHE group).The operative time,intraoperative blood loss,72h hematoma clearance rate,postoperative complications and functional recovery,length of hospital stay,cost and other related indicators were compared between the two groups.Results Compared with NEIHE group,SCPD group had shorter operation time(1.13±0.41)vs.(1.78±0.31)h,less intraoperative blood loss(10.83±3.95)vs.(70.62±43.12)mL,and lower cost(66135.01±33178.64)vs.(95834.93±42784.48)YUAN.However,the 72⁃hour hematoma clearance rate of NEIHE group(86.87±16.31)%was higher than that of SCPD group(74.4±13.78)%,and there were statistical differences(P<0.05);There were no significant differences in postoperative complications,functional recovery and total hospital stay between the two groups(P>0.05).Conclusion SCPD and NEIHE can effectively remove intracranial hematoma,improve nerve function,but SCPD group of shorter operation time,less intraoperative blood loss,and simple operation,suitable for intolerance to patients with general anesthesia surgery,whereas NEIHE hematoma removal more thoroughly.The two groups have no obvious differences in improving the prognosis of function and the overall length of hospital stay.