高血压患者幕上脑出血神经内镜手术治疗的临床分析

Clinical analysis of endoscopic surgery for supratentorial intracerebral hemorrhage in hypertensive patients

目的:研究神经内镜手术治疗高血压幕上出血的疗效及预后状况。方法:选取2014年6月~2016年6月接诊的120例高血压幕上出血患者进行研究。按照随机数表法,随机均分为研究组和对照组。对照组采用小骨窗开颅微创手术进行血肿清除,研究组则采用神经内镜手术对血肿进行清除。治疗后,记录分析两组患者的手术时间、ICU入住时间、术中出血量及术后血肿量,并对治疗前后的GOS、GSS及ADL评分进行分析。术后,调查分析两组患者并发症发生率。结果:研究组患者的手术时间及ICU入住时间明显短于对照组,术中出血量及术后血肿量明显少于对照组,血肿清除率明显高于对照组,两组比较有统计学意义。治疗后,两组患者的GOS评分均显著降低,GSS及ADL评分均显著升高。研究组患者的术后并发症发生率(3.33%)明显低于对照组(26.67%),两组比较有统计学意义。研究组患者的预后状况明显优于对照组,两组比较有统计学意义。结论:神经内镜手术治疗高血压幕上出血,疗效显著,安全性高,值得广泛推广应用。

Objective To study the effect and prognosis of endoscopic surgery for hypertensive supratentorial hemorrhage. Methods From June 2014 to June 2016, 120 patients with hypertensive supratentorial hemorrhage were enrolled in this study. According to the random number table method, were randomly divided into study group and control group. The patients in the control group were treated with minimally invasive craniotomy with small bone window, while the patients in the study group were treated with endoscopic sinus surgery. After treatment, the operation time, ICU stay time, intraoperative blood loss and postoperative hematoma volume of two groups were recorded and analyzed, and before and after treatment, the scores of GOS, GSS and ADL were analyzed. Postoperative complications were analyzed in two groups. Results The operation time and ICU stay time of the study group were shorter than the control group, the amount of intraoperative bleeding and postoperative hematoma volume were significantly less than the control group, hematoma clearance rate was significantly higher than the control group, the two groups was statistically significant. After treatment, the GOS scores of the two groups were significantly lower, and the scores of GSS and ADL were significantly higher. The incidence of postoperative complications of the study group(3.33%) was significantly lower than that in the control group(26.67%), and the difference between the two groups were statistically significant. The prognosis of the patients in the study group was obviously better than that in the control group, and the two groups were statistically significant. Conclusion Endoscopic surgery for hypertensive supratentorial hemorrhage is effective and safe. It is worth popularizing widely.