神经内镜微创手术治疗高血压脑出血疗效及并发症观察

Observation on the efficacy and complications of minimally invasive neuroendoscopic surgery for hypertensive intracerebral hemorrhage

目的:观察高血压脑出血患者应用神经内镜微创手术治疗的疗效及并发症情况。方法:回顾性收集2021年2月至2023年2月期间本院内收治的82例高血压脑出血患者的临床资料。根据患者手术方法不同将其分为开颅手术组(40例)与微创手术组(42例)。分析对比两组的血肿清除率、术后并发症、围术期相关指标、神经功能以及日常生活能力。结果:微创手术组的血肿清除率明显高于开颅手术组(P<0.05)。微创手术组的术后并发症发生率明显低于开颅手术组(P<0.05)。微创手术组的出血量明显少于开颅手术组,手术时间及切口长度、重症监护室观察时间与整体治疗时间均明显短于开颅手术组(P<0.05)。术后1m,微创手术组的美国国立卫生研究院卒中量表(National institute of health stroke scale,NIHSS)评分与日常生活活动能力表(Barthel index,BI)评分均显著优于开颅手术组(P<0.05)。结论:神经内镜微创术治疗高血压脑出血,能提高血肿清除率,减少术后并发症,改善围术期相关指标,提升神经功能以及日常生活能力。

Objective:To observe the efficacy and complications of minimally invasive neuroendoscopic surgery in patients with hypertensive intracerebral hemorrhage.Methods:The clinical data of 82 patients with hypertensive intracerebral hemorrhage treated in our hospital from February 2021 to February 2023 were retrospectively collected.According to different surgical methods,the patients were divided into craniotomy group(40 cases)and minimally invasive surgery group(42 cases).Hematoma clearance rate,postoperative complications,perioperative indexes,neurological function and daily living ability of the two groups were analyzed and compared.Results:The clearance rate of hematoma in minimally invasive surgery group was significantly higher than that in craniotomy group(P<0.05).The incidence of postoperative complications in minimally invasive surgery group was significantly lower than that in craniotomy group(P<0.05).The amount of blood loss in the minimally invasive surgery group was significantly shorter than that in the craniotomy group,and the operation time,incision length,ICU observation time and overall treatment time were significantly shorter than those in the craniotomy group(P<0.05).One month after surgery,the National institute of health stroke scale(NIHSS)and Barthel index(BI)scores of the minimally invasive surgery group were significantly better than those of the craniotomy group(P<0.05).Conclusion:The minimally invasive neuroendoscopic surgery treatment in hypertensive intracerebral hemorrhage can increase the clearance rate of hematoma,reduce postoperative complications,improve perioperative related indexes,and enhance nerve function and daily living ability.