立体定向神经内镜微创手术与常规手术治疗脑包虫病的疗效及安全性分析

Efficacy and Safety of Stereotactic Neuroendoscopic Minimally Invasive Surgery and Conventional Surgery for Cerebral Echinococcosis

目的分析立体定向神经内镜微创手术与常规手术治疗脑包虫病的疗效及安全性。方法回顾性分析我院经立体定向神经内镜微创手术治疗(观察组)及经常规开颅手术治疗(对照组)脑包虫病患者各32例临床资料。记录两组手术相关指标(手术时间、术中出血量、切口长度)、围术期并发症发生情况差异,并比较术前及术后5d炎症反应[降钙素原(PCT)、C反应蛋白(CRP)]、神经功能缺损程度[美国国立卫生研究院神经功能缺损评分(NIHSS)]差异。结果观察组手术时间、术中出血量、切口长度及围术期并发症总发生率均低于对照组(P<0.05)。术后5d时,两组炎症反应(PCT、CRP)均较术前升高(P<0.05),且对照组高于观察组(P<0.05);神经功能缺损程度(NIHSS评分)均较术前降低(P<0.05),且观察组低于对照组(P<0.05)。结论立体定向神经内镜微创手术及常规手术治疗脑包虫病均有效,但立体定向神经内镜术在微创及安全性方面更具有优势,可尽早缓解患者神经功能缺损情况,具有较高的临床应用价值。

Objective To analyze the efficacy and safety of stereotactic neuroendoscopic minimally invasive surgery and conventional surgery for cerebral hydatid disease.Methods The clinical data of 32 patients with echinococcosis treated by stereotactic neuroendoscopic minimally invasive surgery(observation group)and conventional craniotomy(control group)were retrospectively analyzed.The surgical outcomes(surgery time,intraoperative blood loss,length of incision)and perioperative complications were recorded.The inflammatory response was compared between preoperative and postoperative 5 days[procalcitonin(PCT),C-reactive protein(CRP),the degree of neurological deficit[National Institutes of Health neurological deficit score(NIHSS)]differences.Results The total incidence of operative time,intraoperative blood loss,incision length and perioperative complications were lower in the observation group than in the control group(P<0.05).At 5 days after operation,the inflammatory response(PCT,CRP)was higher than that before operation(P<0.05),and the control group was higher than the observation group(P<0.05);the degree of neurological deficit(NIHSS score)was better than that of the pre-reduction was(P<0.05),and the observation group was lower than the control group(P<0.05).Conclusion Stereotactic neuroendoscopic minimally invasive surgery and conventional surgery for cerebral echinococcosis are effective,but stereotactic neuroendoscopy has advantages in minimally invasive and safe,and can relieve neurological deficits as early as possible.It has a high clinical value.