立体定向神经内镜微创手术与常规手术治疗脑包虫病的疗效及安全性分析
|
摘要
目的分析立体定向神经内镜微创手术与常规手术治疗脑包虫病的疗效及安全性。方法回顾性分析我院经立体定向神经内镜微创手术治疗(观察组)及经常规开颅手术治疗(对照组)脑包虫病患者各32例临床资料。记录两组手术相关指标(手术时间、术中出血量、切口长度)、围术期并发症发生情况差异,并比较术前及术后5d炎症反应[降钙素原(PCT)、C反应蛋白(CRP)]、神经功能缺损程度[美国国立卫生研究院神经功能缺损评分(NIHSS)]差异。结果观察组手术时间、术中出血量、切口长度及围术期并发症总发生率均低于对照组(P<0.05)。术后5d时,两组炎症反应(PCT、CRP)均较术前升高(P<0.05),且对照组高于观察组(P<0.05);神经功能缺损程度(NIHSS评分)均较术前降低(P<0.05),且观察组低于对照组(P<0.05)。结论立体定向神经内镜微创手术及常规手术治疗脑包虫病均有效,但立体定向神经内镜术在微创及安全性方面更具有优势,可尽早缓解患者神经功能缺损情况,具有较高的临床应用价值。
Objective To analyze the efficacy and safety of stereotactic neuroendoscopic minimally invasive surgery and conventional surgery for cerebral hydatid disease. Methods The clinical data of 32 patients with echinococcosis treated by stereotactic neuroendoscopic minimally invasive surgery(observation group) and conventional craniotomy(control group) were retrospectively analyzed. The surgical outcomes(surgery time,intraoperative blood loss, length of incision) and perioperative complications were recorded. The inflammatory response was compared between preoperative and postoperative 5 days [procalcitonin(PCT), C-reactive protein(CRP),the degree of neurological deficit [National Institutes of Health neurological deficit score(NIHSS)] differences. Results The total incidence of operative time, intraoperative blood loss, incision length and perioperative complications were lower in the observation group than in the control group(P<0.05). At 5 days after operation, the inflammatory response(PCT, CRP) was higher than that before operation(P<0.05), and the control group was higher than the observation group(P<0.05); the degree of neurological deficit(NIHSS score) was better than that of the pre-reduction was(P<0.05),and the observation group was lower than the control group(P< 0.05). Conclusion Stereotactic neuroendoscopic minimally invasive surgery and conventional surgery for cerebral echinococcosis are effective, but stereotactic neuroendoscopy has advantages in minimally invasive and safe, and can relieve neurological deficits as early as possible. It has a high clinical value.
Objective To analyze the efficacy and safety of stereotactic neuroendoscopic minimally invasive surgery and conventional surgery for cerebral hydatid disease. Methods The clinical data of 32 patients with echinococcosis treated by stereotactic neuroendoscopic minimally invasive surgery(observation group) and conventional craniotomy(control group) were retrospectively analyzed. The surgical outcomes(surgery time,intraoperative blood loss, length of incision) and perioperative complications were recorded. The inflammatory response was compared between preoperative and postoperative 5 days [procalcitonin(PCT), C-reactive protein(CRP),the degree of neurological deficit [National Institutes of Health neurological deficit score(NIHSS)] differences. Results The total incidence of operative time, intraoperative blood loss, incision length and perioperative complications were lower in the observation group than in the control group(P<0.05). At 5 days after operation, the inflammatory response(PCT, CRP) was higher than that before operation(P<0.05), and the control group was higher than the observation group(P<0.05); the degree of neurological deficit(NIHSS score) was better than that of the pre-reduction was(P<0.05),and the observation group was lower than the control group(P< 0.05). Conclusion Stereotactic neuroendoscopic minimally invasive surgery and conventional surgery for cerebral echinococcosis are effective, but stereotactic neuroendoscopy has advantages in minimally invasive and safe, and can relieve neurological deficits as early as possible. It has a high clinical value.
引文
[1]鲁君,王俭.磁共振灌注成像在脑泡型包虫病和其他颅内肉芽肿性疾病鉴别诊断中的应用[J].新疆医科大学学报,2016,39(1):117-120.
[2]Cauteren D V,Millon L,Valk H D,et al.Retrospective study of human cystic echinococcosis over the past decade in France,using a nationwide hospital medical information database[J].Parasitology Research,2016,115(11):1-5.
[3]苗增利,赵旭东,徐幸,等.神经内镜辅助显微手术切除脑干恶变表皮样囊肿一例[J].中华神经外科杂志,2017,33(4):414-415.
[4]赵华,龚道恺.阿司匹林片联合阿托伐他汀钙片治疗急性脑梗死的临床研究[J].中国临床药理学杂志,2016,32(21):1934-1936.
[5]薛垂召,伍卫平,韩帅,等.西藏自治区儿童棘球蚴病患病情况及影响因素分析[J].中国寄生虫学与寄生虫病杂志,2018,36(1):20-25.
[6]Chebli H,Idrissi A L E,Benazzouz M,et al.Human cystic echinococcosis in Morocco:Ultrasound screening in the Mid Atlas through an Italian-Moroccan partnership[J].Plos Neglected Tropical Diseases,2017,11(3):5348-5367.
[7]洪良春,吉健勇,樊才瑞.神经内镜技术与立体定向技术应用于高血压性脑出血的临床疗效[J].立体定向和功能性神经外科杂志,2016,29(5):310-314.
[8]巨清,任月玲,郭育辉,等.脑棘球蚴病的诊治体会[J].中华神经外科杂志,2017,33(8):852-854.
[9]张德文,刘勇,龙林会,等.血清降钙素原检测对慢性肾衰竭患者合并细菌感染的临床应用价值[J].实用医院临床杂志,2017,14(3):59-61.
[10]陈红,陈勃江,梁愈,等.老年社区获得性肺炎患者血清降钙素原和C反应蛋白检测的临床意义[J].实用医院临床杂志,2017,14(5):190-192.
[11]杨利辉,宋纪宁,高海晓,等.神经内镜治疗老年性中等量丘脑出血的研究[J].立体定向和功能性神经外科杂志,2017,30(1):47-48+55.
[2]Cauteren D V,Millon L,Valk H D,et al.Retrospective study of human cystic echinococcosis over the past decade in France,using a nationwide hospital medical information database[J].Parasitology Research,2016,115(11):1-5.
[3]苗增利,赵旭东,徐幸,等.神经内镜辅助显微手术切除脑干恶变表皮样囊肿一例[J].中华神经外科杂志,2017,33(4):414-415.
[4]赵华,龚道恺.阿司匹林片联合阿托伐他汀钙片治疗急性脑梗死的临床研究[J].中国临床药理学杂志,2016,32(21):1934-1936.
[5]薛垂召,伍卫平,韩帅,等.西藏自治区儿童棘球蚴病患病情况及影响因素分析[J].中国寄生虫学与寄生虫病杂志,2018,36(1):20-25.
[6]Chebli H,Idrissi A L E,Benazzouz M,et al.Human cystic echinococcosis in Morocco:Ultrasound screening in the Mid Atlas through an Italian-Moroccan partnership[J].Plos Neglected Tropical Diseases,2017,11(3):5348-5367.
[7]洪良春,吉健勇,樊才瑞.神经内镜技术与立体定向技术应用于高血压性脑出血的临床疗效[J].立体定向和功能性神经外科杂志,2016,29(5):310-314.
[8]巨清,任月玲,郭育辉,等.脑棘球蚴病的诊治体会[J].中华神经外科杂志,2017,33(8):852-854.
[9]张德文,刘勇,龙林会,等.血清降钙素原检测对慢性肾衰竭患者合并细菌感染的临床应用价值[J].实用医院临床杂志,2017,14(3):59-61.
[10]陈红,陈勃江,梁愈,等.老年社区获得性肺炎患者血清降钙素原和C反应蛋白检测的临床意义[J].实用医院临床杂志,2017,14(5):190-192.
[11]杨利辉,宋纪宁,高海晓,等.神经内镜治疗老年性中等量丘脑出血的研究[J].立体定向和功能性神经外科杂志,2017,30(1):47-48+55.