神经内镜辅助下小骨瓣开颅术治疗高血压脑出血

Neuroendoscope Assisted Craniotomy With Small Bone Flap for Hypertensive Intracerebral Hemorrhage

目的探讨神经内镜辅助下小骨瓣开颅术治疗高血压脑出血的临床效果。方法将2015年10月—2018年10月在我院神经外科治疗的240例高血压脑出血患者随机分为两组,对照组采用常规开颅手术治疗,观察组采用神经内镜辅助下小骨瓣开颅术治疗,比较两组患者的血肿清除情况、各项手术指标、术后生活质量。结果观察组术后残余血肿量明显少于对照组,血肿清除率明显高于对照组(P <0.05);观察组手术时间、骨瓣直径、住院时间明显少于对照组(P <0.05);观察组术ADLⅠ～Ⅱ级率明显高于对照组,而ADLⅢ～Ⅳ级率、死亡率明显低于对照组(P <0.05)。结论神经内镜辅助下小骨瓣开颅术治疗高血压脑出血临床效果显著,能有效提升血肿清除效果,减少手术创伤,缩短恢复时间,改善生活质量,具有积极的临床意义。

Objective To evaluate the clinical effect of neuroendoscopy assisted craniotomy in the treatment of hypertensive cerebral hemorrhage.Methods 240 patients with hypertensive intracerebral hemorrhage treated in neurosurgery department from October 2015 to October 2018 were randomly divided into two groups.The control group was treated with conventional craniotomy,and the observation group was assisted with neuroendoscopy assisted craniotomy.Small bone flap craniotomy.The hematomas removal,various surgical indicators and quality of life were compared between the two groups.Results The residual hematoma was significantly less in the observation group than in the control group,and the clearance rate of hematoma was significantly higher than that of the control group(P<0.05).The time of operation,diameter of bone flap and time of hospitalization were significantly less than those of control group(P<0.05).The ADLⅠ~Ⅱrate was significantly higher than that of the control group,while the ADLⅢ~Ⅳrate and mortality rate were significantly lower than that of the control group(P<0.05).Conclusion Neuroendoscopy assisted small bone flap craniotomy in the treatment of hypertensive cerebral hemorrhage has significant clinical effects,can effectively improve hematoma removal,reduce surgical trauma,shorten recovery time,and improve the quality of life,and has positive clinical significance.