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
目的分析不同入路小骨窗开颅显微手术治疗基底节区高血压脑出血的效果。方法选取2019年1月至2022年3月丰城市人民医院收治的88例基底节区高血压脑出血患者作为研究对象,随机分为观察组与对照组,每组44例。两组均行小骨窗开颅显微手术,...目的分析不同入路小骨窗开颅显微手术治疗基底节区高血压脑出血的效果。方法选取2019年1月至2022年3月丰城市人民医院收治的88例基底节区高血压脑出血患者作为研究对象,随机分为观察组与对照组,每组44例。两组均行小骨窗开颅显微手术,对照组采用经颞叶皮质入路手术治疗,观察组采用经侧裂下Rolandic点-岛叶入路手术治疗,比较两组手术情况、血肿清除率、再出血率、术后并发症、术后1个月格拉斯哥昏迷量表(Glasgow coma score,GOS)分级情况及术后1、3、6个月的美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分及世界卫生组织生存质量测定量表(World Health Organization on quality of life brief scale,WHOQOL-BREF)评分。结果两组手术时间、术中出血量、引流管放置时间、行大骨瓣减压例数、住院时间比较差异均无统计学意义;观察组开始手术至颅内压下降时间长于对照组,差异有统计学意义(P<0.05)。观察组术后24 h血肿清除率明显高于对照组,差异有统计学意义(P<0.05);两组再出血率比较差异无统计学意义。观察组术后1个月预后良好率为81.82%,高于对照组的61.36%,差异有统计学意义(P<0.05)。术后1、3、6个月,观察组NIHSS评分均低于对照组,WHOQOL-BREF评分均高于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率为6.82%,低于对照组的25.00%,差异有统计学意义(P<0.05)。结论经侧裂下Rolandic点-岛叶入路小骨窗开颅显微手术治疗基底节区高血压脑出血的效果显著,有助于提升血肿清除率,减少术后并发症发生率,促进术后神经功能的恢复,提高患者预后生存质量。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.
文摘目的分析不同入路小骨窗开颅显微手术治疗基底节区高血压脑出血的效果。方法选取2019年1月至2022年3月丰城市人民医院收治的88例基底节区高血压脑出血患者作为研究对象,随机分为观察组与对照组,每组44例。两组均行小骨窗开颅显微手术,对照组采用经颞叶皮质入路手术治疗,观察组采用经侧裂下Rolandic点-岛叶入路手术治疗,比较两组手术情况、血肿清除率、再出血率、术后并发症、术后1个月格拉斯哥昏迷量表(Glasgow coma score,GOS)分级情况及术后1、3、6个月的美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分及世界卫生组织生存质量测定量表(World Health Organization on quality of life brief scale,WHOQOL-BREF)评分。结果两组手术时间、术中出血量、引流管放置时间、行大骨瓣减压例数、住院时间比较差异均无统计学意义;观察组开始手术至颅内压下降时间长于对照组,差异有统计学意义(P<0.05)。观察组术后24 h血肿清除率明显高于对照组,差异有统计学意义(P<0.05);两组再出血率比较差异无统计学意义。观察组术后1个月预后良好率为81.82%,高于对照组的61.36%,差异有统计学意义(P<0.05)。术后1、3、6个月,观察组NIHSS评分均低于对照组,WHOQOL-BREF评分均高于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率为6.82%,低于对照组的25.00%,差异有统计学意义(P<0.05)。结论经侧裂下Rolandic点-岛叶入路小骨窗开颅显微手术治疗基底节区高血压脑出血的效果显著,有助于提升血肿清除率,减少术后并发症发生率,促进术后神经功能的恢复,提高患者预后生存质量。
