BACKGROUND Chronic subdural hematoma(CSDH)is a common disease in neurosurgery.The traditional treatment methods include burr hole drainage,bone flap craniectomy and other surgical methods,and there are certain complic...BACKGROUND Chronic subdural hematoma(CSDH)is a common disease in neurosurgery.The traditional treatment methods include burr hole drainage,bone flap craniectomy and other surgical methods,and there are certain complications such as recurrence,pneumocephalus,infection and so on.With the promotion of neuroendoscopic technology,its treatment effect and advantages need to be further evaluated.AIM To study the clinical effect of endoscopic small-bone approach in CSDH.METHODS A total of 122 patients with CSDH admitted to our hospital from August 2018 to August 2021 were randomly divided into two groups using the digital table method:the neuroendoscopy group(n=61 cases)and the burr hole drainage group(n=61 cases).The clinical treatment effect of the two groups of patients with CSDH was compared.RESULTS At the early postoperative stage(1 d and 3 d),the proportion of 1/2 re-expansion of brain tissue in the hematoma cavity and the proportion of complete reexpansion was higher in the neuroendoscopy group than in the burr hole drainage group,and the difference between the two groups was statistically significant(P<0.05).The recurrence rate of hematoma in the neuroendoscopy group was lower than that in the burr hole drainage group,and the difference between the two groups was statistically significant(P<0.05).No intracranial hematoma,low cranial pressure,tension pneumocephalus or other complications occurred in the neuroendoscopy group.CONCLUSION The neuroendoscopic approach for the treatment of CSDH can clear the hematoma under direct vision and separate the mucosal lace-up.The surgical effect is apparent with few complications and definite curative effect,which is worthy of clinical promotion and application.展开更多
目的:观察高血压脑出血患者应用神经内镜微创手术治疗的疗效及并发症情况。方法:回顾性收集2021年2月至2023年2月期间本院内收治的82例高血压脑出血患者的临床资料。根据患者手术方法不同将其分为开颅手术组(40例)与微创手术组(42例)。...目的:观察高血压脑出血患者应用神经内镜微创手术治疗的疗效及并发症情况。方法:回顾性收集2021年2月至2023年2月期间本院内收治的82例高血压脑出血患者的临床资料。根据患者手术方法不同将其分为开颅手术组(40例)与微创手术组(42例)。分析对比两组的血肿清除率、术后并发症、围术期相关指标、神经功能以及日常生活能力。结果:微创手术组的血肿清除率明显高于开颅手术组(P<0.05)。微创手术组的术后并发症发生率明显低于开颅手术组(P<0.05)。微创手术组的出血量明显少于开颅手术组,手术时间及切口长度、重症监护室观察时间与整体治疗时间均明显短于开颅手术组(P<0.05)。术后1m,微创手术组的美国国立卫生研究院卒中量表(National institute of health stroke scale,NIHSS)评分与日常生活活动能力表(Barthel index,BI)评分均显著优于开颅手术组(P<0.05)。结论:神经内镜微创术治疗高血压脑出血,能提高血肿清除率,减少术后并发症,改善围术期相关指标,提升神经功能以及日常生活能力。展开更多
基金the Science and Technology Program of Nantong Health Committee,No.MA2019003,No.MA2021017,No.MB2021026,and No.MB2021027Science and Technology Program of Nantong City,No.Key003 and No.JCZ2022040and Kangda College of Nanjing Medical University,No.KD2021JYYJYB025。
文摘BACKGROUND Chronic subdural hematoma(CSDH)is a common disease in neurosurgery.The traditional treatment methods include burr hole drainage,bone flap craniectomy and other surgical methods,and there are certain complications such as recurrence,pneumocephalus,infection and so on.With the promotion of neuroendoscopic technology,its treatment effect and advantages need to be further evaluated.AIM To study the clinical effect of endoscopic small-bone approach in CSDH.METHODS A total of 122 patients with CSDH admitted to our hospital from August 2018 to August 2021 were randomly divided into two groups using the digital table method:the neuroendoscopy group(n=61 cases)and the burr hole drainage group(n=61 cases).The clinical treatment effect of the two groups of patients with CSDH was compared.RESULTS At the early postoperative stage(1 d and 3 d),the proportion of 1/2 re-expansion of brain tissue in the hematoma cavity and the proportion of complete reexpansion was higher in the neuroendoscopy group than in the burr hole drainage group,and the difference between the two groups was statistically significant(P<0.05).The recurrence rate of hematoma in the neuroendoscopy group was lower than that in the burr hole drainage group,and the difference between the two groups was statistically significant(P<0.05).No intracranial hematoma,low cranial pressure,tension pneumocephalus or other complications occurred in the neuroendoscopy group.CONCLUSION The neuroendoscopic approach for the treatment of CSDH can clear the hematoma under direct vision and separate the mucosal lace-up.The surgical effect is apparent with few complications and definite curative effect,which is worthy of clinical promotion and application.
文摘目的:观察高血压脑出血患者应用神经内镜微创手术治疗的疗效及并发症情况。方法:回顾性收集2021年2月至2023年2月期间本院内收治的82例高血压脑出血患者的临床资料。根据患者手术方法不同将其分为开颅手术组(40例)与微创手术组(42例)。分析对比两组的血肿清除率、术后并发症、围术期相关指标、神经功能以及日常生活能力。结果:微创手术组的血肿清除率明显高于开颅手术组(P<0.05)。微创手术组的术后并发症发生率明显低于开颅手术组(P<0.05)。微创手术组的出血量明显少于开颅手术组,手术时间及切口长度、重症监护室观察时间与整体治疗时间均明显短于开颅手术组(P<0.05)。术后1m,微创手术组的美国国立卫生研究院卒中量表(National institute of health stroke scale,NIHSS)评分与日常生活活动能力表(Barthel index,BI)评分均显著优于开颅手术组(P<0.05)。结论:神经内镜微创术治疗高血压脑出血,能提高血肿清除率,减少术后并发症,改善围术期相关指标,提升神经功能以及日常生活能力。
