神经内镜微创手术与小骨窗开颅显微手术治疗高血压性基底节区出血的临床比较

目的比较神经内镜微创手术与小骨窗开颅显微手术治疗高血压性基底节区出血（HBGH）的临床效果。方法收集2012年1月～2014年3月深圳市宝安区沙井人民医院收治的HBGH患者58例,根据手术方式的不同,将患者分为神经内镜微创手术组30例与小骨窗开颅显微手术组28例。观察并比较两组患者手术时间、手术失血量和血肿清除率;根据GOS评分,比较两组患者预后情况。结果①神经内镜微创手术组平均手术时间[（1.9±0.4）h]显著小于小骨窗开颅显微手术组平均手术时间[（3.9±1.2）h],差异有高度统计学意义（P〈0.01）;神经内镜微创手术组平均手术失血量[（35.5±8.5）mL]显著小于小骨窗开颅显微手术组平均手术失血量[（74.5±10.2）mL],差异有高度统计学意义（P〈0.01）;神经内镜微创手术组脑内平均血肿清除率[（87.5±7.2）%]显著高于小骨窗组平均血肿清除率[（76.5±10.5）%],差异有统计学意义（P〈0.05）。②神经内镜微创手术组恢复良好12例,轻度残疾11例,重度残疾3例,植物状态4例;小骨窗开颅显微手术组恢复良好6例,轻度残疾8例,重度残疾10例,植物状态4例。神经内镜微创组患者预后优于小骨窗开颅显微手术组患者（P〈0.05）。结论神经内镜微创手术是一种更具有微创、高效、快速、出血少等特点的HBGH手术方法。

Comparison study of neural endoscopic minimally invasive surgery and small skull-window microsurgical operation in treatment of hypertensive basal ganglionic hemorrhage

Objective To compare the clinical effect of neural endoscopic minimally invasive surgery and small skullwindow microsurgical operation in the treatment of hypertensive basal ganglionic hemorrhage（HBGH）. Methods 58HBGH patients from January 2012 to March 2014 in Shajing People＇s Hospital of Bao＇an District in Shenzhen City were selected and randomly into neural endoscopic minimally invasive surgery group（30 cages） and small skull-window microsurgical operation group（28 cases） according to different methods of operation. The operation time, surgical blood loss and hematoma clearance rate between the two groups were observed and compared; the prognosis conditions between the two groups were compared according to the GOS. Results ①The operation time in neural endoscopic minimally invasive surgery group [（1.9±0.4） h] was lower than that in small skull-window microsurgical operation group[（3.9±1.2） h], the differences were statistically significant（P〈0.01）; the surgical blood loss in neural endoscopic minimally invasive surgery group [（35.5±8.5） mL] was lower than that in small skull-window microsurgical operation group[（74.5±10.2） mL], the differences were statistically significant（P〈0.01）; the hematoma clearance rate in neural endoscopic minimally invasive surgery group [（87.5±7.2） %] was higher than that in small skull-window microsurgical operation group [（76.5±10.5） %], the differences were statistically significant（P〈0.05）. ②12 cases with good recovery, 11cases with moderate disability, 3 cases with severe disability, 4 cases with vegetative survival were found in neural endoscopic minimally invasive surgery group; 6 cases with good recovery, 8 cases with moderate disability, 10 cases with severe disability, 4 cases with vegetative survival were found in small skull-window microsurgical operation group, the prognosis in neural endoscopic minimally invasive surgery group was better than that in small skull-window microsurgical operation group（P?