| 付 亮,王文浩,林志坤,胡 康,张 源,黄 魏,林俊明.神经内镜手术与小骨窗开颅手术治疗高血压脑出血疗效对比的回顾性研究[J].,2022,(9):1691-1695 |
| 神经内镜手术与小骨窗开颅手术治疗高血压脑出血疗效对比的回顾性研究 |
| A Retrospective Study on the Efficacy of Neuroendoscopic Surgery and Small Bone Window Craniotomy in the Treatment of Hypertensive Intracerebral Hemorrhage |
| 投稿时间：2021-11-06 修订日期：2021-11-28 |
| DOI：10.13241/j.cnki.pmb.2022.09.018 |
| 中文关键词: 神经内镜手术 小骨窗开颅手术 高血压脑出血 疗效 回顾性 |
| 英文关键词: Neuroendoscopic surgery Small bone window craniotomy Hypertensive intracerebral hemorrhage Curative effect Retrospective |
| 基金项目:福建省自然科学基金项目（2015J05119） |
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| 中文摘要: |
| 摘要 目的：回顾性对比神经内镜手术与小骨窗开颅手术治疗高血压脑出血（HICH）疗效。方法：回顾性选取2018年7月~2021年3月期间在联勤保障部队第909医院治疗的83例HICH患者的临床资料。根据手术方式的不同，将患者分为A组（n=41）和B组（n=42），A组患者采用小骨窗开颅手术治疗，B组患者采用神经内镜手术治疗，对比两组围术期指标、并发症发生率、神经功能、生活能力、神经损伤指标及预后。结果：与A组相比， B组的手术时间、住院时间明显缩短，术中出血量减少，血肿清除率升高（P<0.05）。B组术后1周美国国立卫生研究院卒中量表（NIHSS）评分低于A组，Barthel指数评分高于A组（P<0.05）。B组术后1周神经元特异性烯醇化酶（NSE）、S100B 蛋白（S100B）、髓鞘碱性蛋白（MBP）、胶质纤维酸性蛋白（GFAP）水平低于A组（P<0.05）。B组的并发症发生率小于A组（P<0.05）。B组的预后良好率高于A组（P<0.05）。结论：神经内镜手术、小骨窗开颅手术治疗HICH均可获得较好的疗效，其中神经内镜手术在缩短手术时间、住院时间，减少术中出血量和并发症发生率，提高血肿清除率，减轻神经功能损伤，促进患者生活能力改善，改善患者预后方面的效果更为显著。 |
| 英文摘要: |
| ABSTRACT Objective: To retrospectively compare the efficacy of neuroendoscopic surgery and small bone window craniotomy in the treatment of hypertensive intracerebral hemorrhage (HICH). Methods: The clinical data of 83 patients with HICH who were treated in the 909th Hospital of Joint Logistics Support Force from July 2018 to March 2021 were retrospectively selected. According to the different surgical methods, the patients were divided into group A(n=41) and group B(n=42). Patients in group A were treated with small bone window craniotomy and patients in group B were treated with neuroendoscopic surgery. The perioperative indexes, incidence of complications, neurological function, living ability, nerve injury indexes and prognosis of the two groups were compared. Results: Compared with group A, group B significantly shortened the operation time and hospital stay, reduced the amount of intraoperative bleeding and increased the clearance rate of hematoma(P<0.05). One week after operation, the National Institutes of Health Stroke Scale (NIHSS) score in group B was lower than that in group A, and the Barthel index score was higher than that in group A(P<0.05). The levels of neuron specific enolase (NSE), S100B protein (S100B), myelin basic protein (MBP) and glial fibrillary acidic protein (GFAP) in group B were lower than those in group A one week after operation (P<0.05). The incidence of complications in group B was lower than that in group A(P<0.05). The rate of good prognosis in group B was higher than that in group A (P<0.05). Conclusion: Neuroendoscopic surgery and small bone window craniotomy can obtain good curative effects in the treatment of HICH. Among them, neuroendoscopic surgery has a more significant effect in shortening the operation time and hospital stay, reducing the amount of intraoperative bleeding and the incidence of complications, improving the clearance rate of hematoma, reducing the damage of nerve function, promoting the improvement of patients' living ability and improving patients' prognosis. |
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