显微与神经内镜手术治疗基底节区高血压脑出血的疗效及安全性比较

目的比较显微与神经内镜手术治疗基底节区高血压脑出血的疗效及安全性。方法选择2017-02—2019-07在新乡市第二人民医院接受治疗的基底节区高血压脑出血患者86例,采用随机数字表法分为对照组与观察组,每组43例。对照组患者接受显微手术治疗,观察组患者接受神经内镜治疗。比较2组患者的疗效及安全性。结果观察组手术时间、术中止血时间、住院时间短于对照组(P<0.05),术中出血量少于对照组(P<0.05)。观察组血肿清除率、术后GCS评分、术后GOS评分高于对照组(P<0.05)。观察组患者切口感染、颅内血肿、颅内感染、肺部感染等总发生率4.65%,低于对照组的27.91%(P<0.05)。观察组血肿复发率为0(0/43),低于对照组的13.95%(6/43)(P<0.05)。2组患者治疗后1周的NIHSS评分低于治疗前,观察组治疗后1周的NIHSS评分为(7.09±1.93)分,低于对照组的(11.98±2.79)分,差异有统计学意义(P<0.05)。结论神经内镜手术治疗高血压基底节区脑出血的效果显著,手术时间和住院时间明显缩短,术中出血量明显减少,血肿清除率明显提高,术后并发症发生率明显降低,有助于改善患者预后,且安全性较高。

Comparison of the efficacy and safety of microsurgery and neuroendoscopic surgery for hypertensive intracerebral hemorrhage in basal ganglia

Objective To compare the efficacy and safety of microsurgery and neuroendoscopic surgery for hypertensive intracerebral hemorrhage in basal ganglia.Methods Eighty-six patients with hypertensive cerebral hemorrhage in the basal ganglia who were treated in the hospital from February 2017 to July 2019 were enrolled.The random number table method was divided into control group and observation group,with 43 cases in each group.Patients in the control group underwent microsurgery,and patients in the observation group received neuroendoscopic treatment.The efficacy and safety of the two groups of patients were compared.Results The operation time,intraoperative hemostasis time,and hospitalization time of the observation group were shorter than those of the control group.The intraoperative blood loss was less in the observation group than in the control group.The hematoma clearance rate,postoperative GCS score,and postoperative GOS score were higher in the observation group.In the control group,the total incidence of incision infection,intracranial hematoma,intracranial infection,and pulmonary infection was 4.65%,which was lower than that of the control group(27.91%).The recurrence rate of hematoma in the observation group was 0(0/43),and was lower than 13.95%(6/43)in the control group.The NIHSS score of the two groups after treatment was lower than that before treatment,and the NIHSS score of the observation group was(7.09±1.93)points 1 week after treatment,which was lower than that of the control group(11.98±2.79)points,the difference was statistically significant(P<0.05).Conclusion Endoscopic surgery is effective in the treatment of cerebral hemorrhage in the basal ganglia of hypertension.The operation time and hospitalization time are significantly shortened,the intraoperative blood loss is significantly reduced,the hematoma clearance rate is significantly improved,and the postoperative complication rate is significantly reduced.The prognosis of patients is improved,and the safety is higher.