摘要
目的分析神经内镜微创手术对基底节脑出血患者脑氧代谢及预后的影响。方法选取于2019年11月至2021年3月国药葛洲坝中心医院诊治的基底节脑出血患者120例分为两组,内镜组60例,行神经内镜手术;开颅组60例,行开颅手术;比较两组脑氧代谢、神经功能及预后。结果内镜组手术时间、术中出血量、ICU入住时间、住院时间均短于开颅组(P<0.01)。内镜组手术结束24 h血肿残余量低于开颅组,血肿清除率高于开颅组(P<0.01)。术后,两组NIHSS量表、GCS量表评分均下降,且内镜组评分低于开颅组(P<0.01)。术后1周两组脑氧代谢均改善,且内镜组改善程度高于开颅组(P<0.01)。内镜组术后3个月预后良好率高于开颅组(80.00%vs 60.00%,χ^(2)=5.714,P=0.017)。内镜组术后3周内并发症发生率低于开颅组(3.33%vs 16.67%,χ^(2)=5.926,P=0.015)。结论神经内镜微创手术可提高基底节脑出血患者的血肿清除率,脑氧代谢恢复显著,预后好。
Objective To analyze the effect of neuroendoscopic minimally invasive surgery on cerebral oxygen metabolism and prognosis in patients with basal ganglia hemorrhage(BGH).Methods A total of 120 patients with BGH diagnosed and treated from November 2019 to March 2021 in Gezhouba Central Hospital of Sinopharm were selected and divided into two groups,60 patients in the endoscopy group underwent neuroendoscopic surgery;60 patients in the craniotomy group underwent craniotomy.The cerebral oxygen metabolism,neurological function and prognosis of the two groups were compared.Results The operation time,intraoperative blood loss,ICU stay and hospital stay in endoscopic group were shorter than those in craniotomy group(P<0.01).Compared with craniotomy group,the residual amount of hematoma was lower,and the hematoma clearance rate was higher in endoscopic group(P<0.01).After operation,the scores of the NIHSS scale and GCS scale of the two groups decreased,and the scores of the endoscopy group were lower than those of the craniotomy group(P<0.01).The cerebral oxygen metabolism of the two groups was improved at 1 week after operation,and the metabolic improvement of the endoscopic group was higher than that of the craniotomy group(P<0.01).The prognosis good rate of the endoscopic group was higher than that of the craniotomy group at 3 months after surgery(80.00%vs 60.00%,χ^(2)=5.714,P=0.017).The incidence of complications in the endoscopic group was lower than that in the craniotomy group within 3 weeks after surgery(3.33%vs 16.67%,χ^(2)=5.926,P=0.015).Conclusion Neuroendoscopic surgery can improve the hematoma clearance rate of patients with BGH,the cerebral oxygen metabolism recovers significantly,and the prognosis is good.
作者
程浩
陈晟
徐昌林
李毅
高涢
刘从国
CHENG Hao;CHEN Sheng;XU Chang-lin;LI Yi;GAO Yun;LIU Cong-guo(Department of Neurosurgery,The Third Clinical Medical College of China Three Gorges University,Gezhouba Central Hospital of Sinopharm,Yichang,Hubei 443000,China)
出处
《中国临床研究》
CAS
2021年第11期1454-1457,共4页
Chinese Journal of Clinical Research
关键词
神经内镜
基底节
脑出血
脑氧代谢
Neuroendoscopy
Basal ganglia
Cerebral hemorrhage
Cerebral oxygen metabolism
