神经内镜下微创手术治疗丘脑出血破入脑室的疗效分析

Analysis of Curative Effect of Neuroendoscopic Minimally Invasive Surgery in the Treatment of Thalamic Hemorrhage Breaking into the Ventricle

目的探讨神经内镜下微创手术治疗丘脑出血破入脑室的疗效。方法2021年5月—2022年5月对广元市中心医院收治的64例丘脑出血患者展开回顾性分析。依据患者的治疗方案分组,其中将单纯脑室外引流治疗方案的患者编入对照组(n=32),在神经内镜辅助下进行血肿清除术+脑室外引流治疗的患者编入内镜组(n=32)。比较两组手术治疗情况、并发症发生率及预后情况。结果内镜组血肿清除率达(72.81±6.12)%,高于对照组的(33.93±10.28)%,差异有统计学意义(t=18.384,P<0.001)。内镜组并发症总发生率为28.13%,低于对照组的53.13%,差异有统计学意义(χ^(2)=4.146,P=0.042)。内镜组预后优良率为65.63%,高于对照组的37.50%,差异有统计学意义(χ^(2)=5.067,P=0.024)。结论神经内镜下微创手术治疗丘脑出血破入脑室血肿清除率高,可显著减少颅内感染、再出血等的发生,从而获得满意预后效果。

Objective To explore the curative effect of neuroendoscopic minimally invasive surgery in the treatment of thalamic hemorrhage breaking into the ventricle.Methods Retrospective analysis of 64 patients with thalamic hemorrhage admitted to Guangyuan Central Hospital from May 2021 to May 2022.Patients were grouped according to their treatment plan.Among them,the patients with simple external ventricular drainage treatment were enrolled in the control group(n=32),and the patients with neuroendoscope-assisted hematoma evacuation+external ventricular drainage were enrolled in the endoscopic group(n=32).The surgical treatment,complications rate and prognosis were compared between the two groups.Results The clearance rate of hematoma in the endoscopic group was(72.81±6.12)%,which was higher than(33.93±10.28)%in the control group,the difference was statistically significant(t=18.384,P<0.001).The total incidence of complications in the endoscopy group was 28.13%,which was lower than 53.13%in the control group,the difference was statistically significant(χ^(2)=4.146,P=0.042).The excellent and good prognosis rate in the endoscopy group was 65.63%,which was higher than 37.50%in the control group,the difference was statistically significant(χ^(2)=5.067,P=0.024).Conclusion Neuroendoscopic minimally invasive surgery in the treatment of thalamic hemorrhage breaking into the ventricle has a high clearance rate,can significantly reduce the occurrence of intracranial infection and rebleeding,and thus obtain a satisfactory prognosis.