球囊扩张引导管状脑压板联合神经内镜辅助治疗基底节区脑出血的效果分析

Effect of Treatment of Cerebral Hemorrhage in Basal Ganglia Region with Balloon Dilatation and Tubular Brain Pressure Plate Combined with Neuroendoscope

目的:探讨球囊扩张引导管状脑压板联合神经内镜辅助下手术治疗基底节区脑出血的临床应用效果。方法:回顾性分析2018年1月—2021年6月玉林市第一人民医院神经外科收治的90例基底节区脑出血患者临床资料,根据不同手术方式分为观察组(内镜组)、对照组(开颅组)。观察组45例,进行了球囊扩张引导管状脑压板联合神经内镜辅助下手术治疗基底节区脑出血;对照组45例,进行了传统开颅血肿清除术。收集两组患者术前术后GCS评分、术前血肿量、手术时间、术中出血量、再出血率、GOS评分等相关数据。对比两组患者血肿清除率、术中及术后相关指标、术后并发症等情况。结果:观察组与对照组在术前脑出血量、术前GCS评分、术中失血量方面,差异无统计学意义(P>0.05);观察组患者的手术时间短于对照组,血肿清除率低于对照组、术后GOS评分优于对照组,差异有统计学意义(t=13.21,-5.47,14.10,P<0.05)。结论:球囊扩张引导管状脑压板联合神经内镜辅助治疗基底节区脑出血是安全有效的,在手术时间、术后并发症、患者预后方面均优于传统开颅血肿清除术。

Objective: To investigate the clinical effect of balloon-guided and catheter-like brain compression plate combined with neuroendoscope-assisted surgery in the treatment of basal ganglia hemorrhage. Methods: The clinical data of 90 patients with intracerebral hemorrhage in the basal ganglia region admitted to the Department of Neurosurgery, the First People's Hospital of Yulin City from January, 2018 to June, 2021 were analyzed retrospectively, the patients were divided into two groups according to different operation methods: the observation group(endoscopic group) and the control group(craniotomy group). The observation group(45 cases) were treated with balloon dilation and catheter-guided brain compression plate combined with neuroendoscopeassisted operation for basal ganglia intracerebral hemorrhage, and the control group(45 cases) were treated with traditional craniotomy. The data of GCS score, preoperative hematoma volume, operative time, intraoperative bleeding volume, rebleeding rate and GOS score were collected. The clearance rate of hematoma, relevant indexes during and after operation, and postoperative complications were compared between the two groups. Results: There was no significant difference between the two groups in preoperative cerebral hemorrhage volume, preoperative GCS score and intraoperative blood loss(P>0.05). The operation time of the observation group was shorter than that of the control group, the clearance rare of hematoma and the incidence of postoperative complications were lower than those of the control group, and the GOS score was better than that of the control group. There was statistically significant difference between the two groups(t=13.21,-5.47, 14.10;P<0.05). Conclusion: The treatment of intracerebral hemorrhage in the basal ganglia region with balloon dilatation and catheter-like brain pressure plate combined with neuroendoscope is safe and effective. It is superior to conventional craniotomy in operation time, postoperative complications and prognosis of patients.