神经内镜下经额锁孔入路对基底节区脑出血患者神经功能恢复及安全性研究

Neuroendoscopic Transfrontal Keyhole Approach for Neurological Function Recovery and Safety in Patients with Basal Ganglia Cerebral Hemorrhage

目的探究神经内镜下经额锁孔入路对基底节区脑出血患者神经功能恢复及安全性的影响。方法选择本院2020年3月~2022年3月收治的102例基底节区脑出血患者,按手术方式不同设为49例对照组(显微镜下经颞锁孔入路)与53例研究组(神经内镜下经额锁孔入路)。比较两组手术效果、血肿清除率、神经功能(GCS评分)、日常生活能力(MBI评分)及并发症情况。结果两组住院时间及血肿清除率相比无差异(P>0.05);研究组手术时间比对照组短,术中出血量比对照组少(P<0.05);两组术后神经纤维束各向异性值、相对各向异性值均比术前高,且研究组比对照组高(P<0.05);两组术后GCS评分、MBI评分均比术前高,且研究组术后GCS评分比对照组高(P<0.05);两组再出血、脑梗死等并发症发生率相比无差异(P>0.05)。结论神经内镜下经额锁孔入路治疗基底节区脑出血安全有效,可明显减少患者术中出血,促进其神经功能恢复。

Objective To investigate the effect of neuroendoscopic transfrontal keyhole approach on neurological function recovery and safety in patients with basal ganglia cerebral hemorrhage.Methods A total of 102 patients with basal ganglia cerebral hemorrhage admitted to our hospital from March 2020 to March 2022 were selected and divided into control group(n=49)and study group(n=53)according to different surgical methods.The operation effect,hematoma clearance rate,neurological function(GCS score),ability of daily living(MBI score)and complications were compared between the two groups.Results There was no difference in the length of hospital stay and hematoma clearance rate between the two groups(P>0.05).The operation time of the study group was shorter than that of the control group,and the intraoperative blood loss was less than that of the control group(P<0.05).The anisotropy value and relative anisotropy value of nerve fiber bundle after operation in the two groups were higher than those before operation,and the study group was higher than the control group(P<0.05).The postoperative GCS score and MBI score of the two groups were higher than those before operation,and the postoperative GCS score of the study group was higher than that of the control group(P<0.05).There was no difference in the incidence of complications such as rebleeding and cerebral infarction between the two groups(P>0.05).Conclusion Neuroendoscopic transfrontal keyhole approach is safe and effective in the treatment of basal ganglia cerebral hemorrhage,which can significantly reduce intraoperative bleeding and promote the recovery of neurological function.