电磁导航辅助神经内镜血肿清除术治疗高血压脑出血患者的临床效果

Clinical Effect of Electromagnetic Navigation Assisted Neuroendoscopic Hematoma Clearance Surgery in the Treatment of Hypertensive Intracerebral Hemorrhage

【目的】探讨电磁导航辅助神经内镜血肿清除术治疗高血压脑出血(HICH)患者的效果及对患者短期预后的影响。【方法】回顾性分析2020年3月至2023年3月本院收治的102例HICH患者的临床资料,根据手术方案不同将其分为观察组(行电磁导航辅助神经内镜血肿清除术治疗)和对照组(行常规神经内镜血肿清除术治疗),每组51例。比较两组围术期指标、手术前后美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分、氧化应激指标[氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)]、血管内皮功能指标[血管升压素(AVP)、血管生成素-1(Ang-1)、内皮素(ET)]及并发症发生情况。【结果】观察组术后血肿残余量低于对照组,血肿清除率高于对照组,住院时间短于对照组,差异有统计学意义(P<0.05)。术后1个月、3个月,两组NIHSS、mRS评分低于术前,且观察组低于对照组,差异有统计学意义(P<0.05)。术后1个月,两组血清SOD、GSH-Px水平高于术前,血清MDA水平低于术前,且两组上述指标比较,差异均有统计学意义(P<0.05)。术后1个月,两组血清AVP、Ang-1、ET水平低于术前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。【结论】电磁导航辅助神经内镜血肿清除术有助于改善HICH患者神经功能及预后,优化围术期指标,缓解氧化应激状态,改善患者血管内皮功能,降低并发症发生风险。

【Objective】To investigate the efficacy of electromagnetic navigation assisted neuroendoscopic hematoma evacuation in the treatment of hypertensive intracerebral hemorrhage(HICH)patients and its impact on short-term prognosis.【Methods】A retrospective analysis was conducted on the clinical data of 102 HICH patients admitted to our hospital.According to different surgical plans,they were divided into the observation group(treated with electromagnetic navigation assisted neuroendoscopic hematoma evacuation)and the control group(treated with conventional neuroendoscopic hematoma evacuation),with 51 cases in each group.Two groups of perioperative indicators,National Institutes of Health Stroke Scale(NIHSS)scores before and after surgery,Modified Rankin Scale(mRS)scores,oxidative stress indicators(SOD,GSH-Px,MDA),vascular endothelial function indicators(AVP,Ang-1,ET),and incidence of complications were compared.【Results】The residual hematoma volume and hematoma clearance rate in the observation group were lower than those in the control group after surgery,and the hospitalization time was shorter than that in the control group,with statistical significance(P<0.05).At 1 and 3 months after surgery,the NIHSS and mRS scores in both groups were lower than before surgery,and the observation group was lower than the control group,with statistical significance(P<0.05).One month after surgery,the levels of SOD and GSH-Px in the serum of both groups were higher than before surgery,and the level of MDA in the serum was lower than before surgery.The differences in these indicators between the two groups were statistically significant(P<0.05).One month after surgery,the levels of serum AVP,Ang-1,and ET in both groups were lower than before surgery,and the observation group was lower than the control group,with statistical significance(P<0.05).The incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).【Conclusion】Electromagnetic navigation assisted neuroendoscopic hematoma removal surgery can improve neurological function and prognosis in HICH patients,optimize perioperative indicators,alleviate oxidative stress,improve vascular endothelial function,and reduce the risk of complications.