神经内镜手术治疗分隔型硬膜下血肿的疗效

Efficacy of neuroendoscopic surgery in treating septatus subdural hematoma

目的:分析神经内镜手术治疗分隔型慢性硬膜下血肿(CSDH)的疗效。方法:选择2020年1月至2024年1月某医院神经外科收治的80例分隔型CSDH患者,按手术方式分为对照组(n=42)和研究组(n=38),对照组实施钻孔引流术治疗,研究组实施神经内镜辅助钻孔引流术治疗,比较两组手术指标、手术前后神经功能和日常生活能力,并统计两组并发症发生情况以及随访3个月的血肿复发情况。结果:研究组血肿消失时间以及住院时间较对照组短(P<0.05),术后1d血肿清除率较对照组高(P<0.05),术中出血量与对照组比较无显著性差异(P>0.05),但手术时间较对照组长(P<0.05);两组术后1个月NIHSS评分、CSS评分较术前低(P<0.05),且研究组术后1个月NIHSS评分、CSS评分较对照组低(P<0.05);两组术后1个月ADL评分较术前高(P<0.05),且研究组术后1个月ADL评分较对照组高(P<0.05);对照组并发症总发生率为23.81%,与研究组的15.79%比较,无显著性差异(P>0.05);随访3个月,对照组有5例患者血肿复发,复发率为11.90%(5/42),研究组有1例患者血肿复发,复发率为2.63%(1/38),无显著性差异(P>0.05)。结论:神经内镜辅助钻孔引流术治疗分隔型CSDH更有利于提升血肿清除率,并促进分隔型CSDH患者的神经功能恢复,同时增强其日常生活能力,安全可靠。

Objective:To analyze the efficacy of neuroendoscopic surgery in the treatment of septatus chronic subdural hematoma(CSDH).Methods:A total of 80 patients with septatus CSDH in the neurosurgery department of huaihe Hospital,Henan university from January 2020 to January 2024 were selected,and were divided into control group(n=42)and study group(n=38)according to the surgical methods.The control group carried out trepanation and drainage,while the study group was treated with neuroendoscopic-assisted trepanation and drainage.The surgical indexes,neurological function and daily living ability before and after surgery were compared between the two groups.The occurrence of complications and hematoma recurrence after 3 months of follow-up were counted.Results:The hematoma disappearance time and hospitalization time in study group were shorter than those in control group(P<0.05),and the clearance rate of hematoma at l day after surgery was higher than that in control group(P<0.05),but there was no significant difference in the intraoperative blood loss compared to control group(P>0.05),and the surgical time was longer than that in control group(P<0.05).The NIHSS score and CSS score in both groups were reduced at l month after surgery compared to before surgery(P<0.05),and the NIHSS score and CSS score in study group at l week after surgery were lower than those in control group(P<0.05).The ADL score at l month after surgery was higher in both groups than that before surgery(P<0.05),and the ADL score in study group was higher than that in control group at l month after surgery(P<0.05).The total incidence rate of complications in control group was 23.81%,which was no significant different from 15.79%in study group(P>0.05).After 3 months of follow-up,5 patients in control group had hematoma recurrence,with a recurrence rate of 11.90%(5/42),and 1 patient in study group had hematoma recurrence,with a recurrence rate of 2.63%(1/38)(P>0.05).Conclusion:Neuroendoscopic-assisted trepanation and drainage for septated CSDH is conducive to improving hematoma clearance rate,promoting the recovery of neurological function,and enhancing the daily living ability in patients with septated CSDH,which is safe and reliable.