立体定向微创手术治疗对脑干出血患者血肿清除率、运动诱发电位及神经功能缺损程度的影响分析

Effect of Stereotactic Minimally Invasive Surgery on Hematoma Clearance Rate,Motor Evoked Potential and Degree of Neurological Deficit in Pa⁃tients with Brainstem Hemorrhage

目的探讨立体定向微创手术治疗对脑干出血对血肿清除、运动诱发电位、神经功能缺损的影响。方法随机选取2021年1月—2024年1月汶上县人民医院收治的100例脑干出血者作为研究对象,按治疗方法不同分为观察组(n=50)和对照组(n=50),对照组采取常规开颅血肿清除术治疗,观察组选择立体定向微创手术下处理出血情况。对比两组的血肿清除率、治疗前与治疗后的运动诱发电位指标变化、神经功能、认知功能以及相关并发症发生情况。结果观察组的血肿清除率为100.00%(50/50),高于对照组的84.00%(42/50),差异有统计学意义(χ^(2)=6.658,P<0.05)。治疗14 d,观察组上、下肢运动诱发电位均低于对照组,差异有统计学意义(P<0.05)。治疗14 d和30 d观察组的美国国立卫生研究院卒中量表评分均低于对照组,简易智力状态检查量表评分均高于对照组,差异有统计学意义(P均<0.05)。观察组的并发症总发生率为2.00%(1/50),低于对照组的16.00%(8/50),差异有统计学意义(χ^(2)=4.395,P<0.05)。结论针对脑干出血患者,采取立体定向微创手术相较常规治疗,可以提高血肿清除率,缩短上下肢运动诱发电位值,使得神经缺损情况得以改变,并促进患者术后认知功能恢复,降低并发症发生率。

Objective To investigate the effect of minimally invasive stereotactic surgery on brain stem hemorrhage,removal of hematoma,motor evoked potential and neurological function defect.Methods A total of 100 patients with brainstem hemorrhage admitted to Wenshang County People's Hospital from January 2021 to January 2024 were randomly selected as the research objects.According to different treatment methods,they were divided into observation group(n=50)and control group(n=50).The control group was treated with conventional craniotomy hematoma removal,while the observation group was treated with minimally invasive stereotactic surgery.The hematoma clearance rate,the changes of motor evoked potential indexes,neurological function,cognative function and related complications before and after treatment were compared between the two groups.Results The hematoma clearance rate of the observation group was 100.00%(50/50),which was higher than that of the control group 84.00%(42/50),and the difference was statistically significant(χ^(2)=6.658,P<0.05).After 14 days of treatment,the motor evoked potentials of upper and lower limbs in the observation group were lower than those in the control group,and the differences were statistically significant(both P<0.05).On the 14 days and 30 days of treatment,the scores of National Institutes of Health Stroke Scale in the observation group were lower than those in the control group,and the scores of Mini-mental State Examination Scale were higher than those in the control group,the differences were statistically significant(all P<0.05).The total incidence of complications in the observation group was 2.00%(1/50),which was lower than 16.00%(8/50)in the control group,and the difference was statistically significant(χ^(2)=4.395,P<0.05).Conclusion Compared with conventional treatment,stereotactic minimally invasive surgery for patients with brain stem hemorrhage can improve the clearance rate of hematoma,shorten the motor evoked potential value of upper and lower limbs,change the nerve defect,promote the postoperative cognitive function recovery of patients,and reduce the incidence of complications.