内镜手术与开颅手术治疗老年晚期自发性脑出血患者的治疗效果对比研究

Comparison of Therapeutic Effect of Endoscopic Surgery and Craniotomy in Elderly Patients with Spontaneous Intracerebral Hemorrhage

目的比较内镜手术与开颅手术治疗老年晚期自发性脑出血患者的效果。方法选取2020年11月—2023年3月在张家港市第五人民医院、张家港市第一人民医院神经外科收治的100例老年晚期脑出血(Intra cerebral Hemorrhage,ICH)患者,根据随机数表法将患者分为对照组(接受开颅手术治疗,50例)和观察组(接受内镜手术治疗,50例)。比较两组患者的手术疗效、预后、并发症发生率和神经因子水平。结果观察组的手术持续时间(149.40±36.00)min和术中失血量(78.32±16.35)mL显著低于对照组,差异有统计学意义(t=4.596、4.369,P均<0.05)。观察组的重症监护室(Intensive Care Unit,ICU)停留时间和住院时间显著短于对照组,差异有统计学意义(P均<0.05)。观察组的肺部感染发生率低于对照组,格拉斯哥预后评分(Glasgow Out come Scale,GOS)、日常生活能力(Advance Decline Line,ADL)评分显著高于对照组,差异有统计学意义(P均<0.05)。观察组神经营养因子水平改善程度显著优于对照组,差异有统计学意义(P<0.05)。结论较开颅手术治疗,内镜手术在老年晚期自发性脑出血患者的治疗中效果更为显著,且安全性高,在未来的临床应用中具有使用价值。

Objective To compared the effect of endoscopic versus open surgery in the treatment of elderly patients with advanced spontaneous cerebral hemorrhage.Methods 100 elderly patients with intracerebral hemorrhage(ICH)admitted to the neurosurgery department of Zhangjiagang Fifth People's Hospital and Zhangjiagang First People's Hos pital from November 2020 to March 2023 were included.According to the random number table method,the patients were divided into two groups,control group(50 cases received craniotomy)and observation group(50 cases received endoscopic surgery).The operative effect,prognosis,complication rate and neurofactor level were compared between the two groups.Results The operative time(149.40±36.00)min and the intraoperative blood loss(78.32±16.35)mL in the observation group were significantly lower than those in the control group,the differences were statistically signifi cant(t=4.596,4.369,both P<0.05).The length of stay in intensive care unit(ICU)and hospital stay in the observation group were significantly shorter than those in the control group,and the differences were statistically significant(both P<0.05).The incidence of pulmonary infection in the observation group was lower than that in the control group,Glasgow outcome score(GOS)and advance decline line(ADL)score were significantly higher than those in control group,the differences were statistically significant(all P<0.05).The improvement degree of neurotrophic factor in the observation group was significantly better than that in the control group,the difference was statistically significant(P<0.05).Conclusion Compared with craniotomy,endoscopic surgery has a more significant effect and high safety in the treatment of elderly patients with advanced spontaneous cerebral hemorrhage,which makes it valuable to use in future clinical applications.