神经内镜微创手术治疗基底核区高血压性脑出血的疗效观察

目的 探讨神经内镜微创手术治疗基底核区高血压性脑出血的临床疗效。方法 回顾性分析2015年6月—2016年10月阜阳市人民医院收治的60例基底核区高血压性脑出血患者的临床资料。依手术方式分为对照组和观察组,每组30例,分别实施常规开颅血肿清除手术和神经内镜微创手术,比较两组临床疗效及手术情况。结果 观察组与对照组手术时间分别为1.1(0.9,1.5)h和3.1(2.5,3.7)h,术中出血量分别为48(44,60)mL和300(298,326)mL,住院时间分别为(13.67±1.92)d和(20.53±2.03)d,血肿清除率分别为(92.27±4.28)%和(85.17±9.01)%,差异均有统计学意义(Z=-6.504、-6.681, t=3.871、-13.470, P值均<0.01)。观察组术后随访恢复良好率为83.33%(25/30),明显高于对照组的56.67%(17/30),差异有统计学意义(χ²=5.079, P<0.05)。结论 对基底核区高血压性脑出血患者手术治疗,神经内镜微创手术相比于常规开颅血肿清除术可缩短手术时间,减少术中出血量,提高血肿清除率,改善预后,可以在临床推广应用。

Efficacy of minimally invasive neuroendoscopic surgery on the treatment of hypertensive cerebral hemorrhage in basal ganglia

Objective To explore the clinical efficacy of minimally invasive neuroendoscopic surgery for the evacuation of hypertensive cerebral hemorrhage in basal ganglia.Methods The clinical data of 60 patients with hypertensive basal ganglia hemorrhage treated in the Fuyang Affliated Hospital of Bengbu Medical College from June 2015 to October 2016 were retrospectively analyzed. The patients were divided into control group (n=30), in which patients underwent conventional craniotomy, and observation group (n=30) receiving neuroendoscopic minimally invasive surgery.Results Compared with the control group, the observation group showed shorter operative time 1.1 (0.9, 1.5) h vs. 3.1 (2.5, 3.7) h], less intraoperative bleeding 48 (44, 60) mL vs. 300 (298, 326) mL] and less hospital stays (13.67±1.92) d vs. (20.53±2.03) d] and higher evacuation rate (92.27±4.28)% vs. (85.17±9.01) %], and the differences were statistically significant (Z=-6.504, Z=-6.681, t=3.871, t=-13.470, all P values<0.01). In the postoperative follow-up, the recovery rate in the observation group (83.33%, 25/30) were significantly higher than that in the control group(56.67%, 17/30), with statistically significant difference (χ²=5.079, P<0.05).Conclusions Minimally invasive neuroendoscopic surgery has shorter operation time and less intraoperative blood loss, higher evacuation rate, resulting in better prognosis than conventional craniotomy. It can be widely applied in clincal practices.