显微手术与神经内镜手术治疗高血压性脑出血破入脑室疗效对比研究

Comparative Study on the Efficacy of Microsurgery and Neuroendoscopic Surgery in the Treatment of Patients with Hypertensive Cerebral Hemorrhage that Breaks into the Ventricle

目的评价不同微创手术方法治疗老年高血压脑出血的疗效。方法方便选取2021年3月—2023年2月于莒南县人民医院治疗的76例高血压脑出血破入脑室老年患者为研究对象,采用随机数表法分为神经内镜手术组与显微手术组,各38例。比较两组手术相关指标、血肿清除率及预后情况。结果与显微手术组比较,神经内镜手术组重症监护室停留时间、带管时间与手术时间均较短,且术后1、3、7 d的脑室血肿清除率显著提高,差异有统计学意义(P均<0.001)。神经内镜手术组术后7 d的格拉斯哥昏迷指数评分为(11.62±2.69)分,优于显微手术组;预后良好率(86.84%)高于显微手术组,差异有统计学意义(t=5.006,P<0.001;χ^(2)=4.659,P=0.031)。结论与显微术式比较,高血压脑出血破入脑室患者应用神经内镜术式治疗后,血肿清除效果更好,脑室引流管留置时间与重症监护室停留时间更短,颅内感染率更低,预后更佳。

Objective To evaluate the efficacy of different minimally invasive surgical methods in the treatment of elderly with hypertensive cerebral hemorrhage.Methods A total of 76 elderly patients with hypertensive cerebral hemorrhage rupturing into the ventricles who were treated in Junan County People's Hospital from March 2021 to February 2023 were conveniently selected as the study objects.The patients were divided into neuroendoscopic surgery group and microsurgery group using random number table method,with 38 cases in each group.The surgical relevant indicators,hematoma clearance rate and prognostic situation were compared between the two groups.Results Compared with the microsurgery group,the neuroendoscopic surgery group had shorter intensive care unit stay time,tube time and operation time,and the clearance rate of intraventricular hematoma was significantly improved on the 1st day,3rd day,and 7th day,and the differences were statistically significant(all P<0.001).The score of Glasgow Coma Index(11.62±2.69)point at 7th day after surgery was better than that of the microsurgery group,and the good prognosis rate of(86.84%)was higher than that of the microsurgery group,and the differences were statistically significant(t=5.006,P<0.001;χ^(2)=4.659,P=0.031).Conclusion Compared with the microsurgery,neuroendoscopic surgery has better hematoma removal effect,shorter ventricular drainage tube indwelling time and ICU stay,and lower intracranial infection rate in patients with hypertensive cerebral hemorrhage that ruptures into the ventricle,and better prognosis.