高血压脑出血神经内镜微创手术与开颅血肿清除术的效果
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摘要
目的探讨高血压脑出血神经内镜微创手术与开颅血肿清除术的效果。方法将2017年11月-2018年11月在我院神经外科治疗的88例高血压脑出血患者随机分为两组,对照采用常规开颅血肿清除术,观察组采用神经内镜微创手术,比较两组患者的各项手术指标、并发症发生率、GCS评分变化。结果观察组手术时间、术中出血量、ICU住院时间、术后再出血率明显少于对照组,而血肿清除率明显高于对照组(P<0.05);观察组消化道出血、肺部感染、尿路感染、局限性脑积水、硬膜下积液等并发症发生率明显低于对照组(P<0.05);观察组术后1d、3d、7d、3个月GCS评分均明显高于对照组(P<0.05)。结论高血压脑出血神经内镜微创手术治疗的效果更佳,创伤小,血肿清除率高,并发症发生率低,更值得在临床推荐使用。
Objective To investigate the effect of neuroendoscopic minimally invasive surgery and craniotomy for hypertensive intracerebral hemorrhage. Methods 88 patients with hypertensive intracerebral hemorrhage treated by neurosurgery in our hospital from November 2017 to November 2018 were randomLy divided into two groups.The control group was treated with routine craniotomy and the observation group was treated with neuroendoscopic minimally invasive surgery. Results The operation time, intraoperative bleeding volume, ICU hospitalization time and the rate of re-bleeding after operation in the observation group were significantly less than those in the control group,while the clearance rate of hematoma was significantly higher than that in the control group(P<0.05); the incidence of complications such as gastrointestinal bleeding, pulmonary infection, urinary tract infection, limited hydrocephalus and subdural effusion in the observation group was significantly lower than that in the control group(P<0.05); the incidence of complications such The GCS scores of 3 months were significantly higher than those of the control group(P<0.05).Conclusion Neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage has better effect,less trauma, high clearance rate of hematoma and low incidence of complications, which is more worthy of clinical recommendation.
Objective To investigate the effect of neuroendoscopic minimally invasive surgery and craniotomy for hypertensive intracerebral hemorrhage. Methods 88 patients with hypertensive intracerebral hemorrhage treated by neurosurgery in our hospital from November 2017 to November 2018 were randomLy divided into two groups.The control group was treated with routine craniotomy and the observation group was treated with neuroendoscopic minimally invasive surgery. Results The operation time, intraoperative bleeding volume, ICU hospitalization time and the rate of re-bleeding after operation in the observation group were significantly less than those in the control group,while the clearance rate of hematoma was significantly higher than that in the control group(P<0.05); the incidence of complications such as gastrointestinal bleeding, pulmonary infection, urinary tract infection, limited hydrocephalus and subdural effusion in the observation group was significantly lower than that in the control group(P<0.05); the incidence of complications such The GCS scores of 3 months were significantly higher than those of the control group(P<0.05).Conclusion Neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage has better effect,less trauma, high clearance rate of hematoma and low incidence of complications, which is more worthy of clinical recommendation.
引文
[1]徐兴华,陈晓雷,刘磊,等.高血压脑出血神经内镜手术与传统开颅手术疗效比较[J].解放军医学院学报,2015,36(4):309-312.
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[6]邱翔,刘伟,刘冰,等.神经内镜微创与开颅微创血肿清除术治疗高血压脑出血的临床疗效比较[J].安徽医药,2018,22(4):674-677.
[7]周瑞涛,毕艳平,李永利.高血压脑出血神经内镜微创手术与开颅血肿清除术的临床效果对比[J].中国保健营养,2017,27(22):134-135.
[8]于本帅.神经内镜微创手术与开颅血肿清除术治疗高血压脑出血的临床比较[J].当代医学,2017,23(31):58-60.
[9]古运涛.神经内镜微创手术与开颅血肿清除术治疗高血压脑出血的临床分析[J].世界临床医学,2016,10(17):35,39.
[10]李学.比较高血压脑出血神经内镜微创手术与开颅血肿清除术的临床特点与疗效[J].继续医学教育,2016,30(9):112-113.
[11]白福平.高血压脑出血神经内镜微创手术与开颅血肿清除术的临床比较分析[J].医药前沿,2017,7(27):181-182.
[2]黎会,吴雪松,潘荣南,等.高血压脑出血神经内镜微创手术与开颅血肿清除术的临床比较分析[J].广州医科大学学报,2017,45(4):34-36.
[3]黄毅,陈晓雷,黄建荣,等.幕上高血压脑出血神经内镜微创手术与开颅血肿清除术的疗效比较[J].中国实用神经疾病杂志,2014,17(10):1-4.
[4]葛新,陈晓雷,孙吉庆,等.神经内镜微创手术与开颅血肿清除术治疗高血压脑出血疗效比较[J].中国神经精神疾病杂志,2016,42(10):605-608.
[5]闫亮.对比观察神经内镜微创手术与开颅血肿清除术治疗高血压脑出血的疗效[J].中西医结合心血管病杂志,2015,3(5):78-79.
[6]邱翔,刘伟,刘冰,等.神经内镜微创与开颅微创血肿清除术治疗高血压脑出血的临床疗效比较[J].安徽医药,2018,22(4):674-677.
[7]周瑞涛,毕艳平,李永利.高血压脑出血神经内镜微创手术与开颅血肿清除术的临床效果对比[J].中国保健营养,2017,27(22):134-135.
[8]于本帅.神经内镜微创手术与开颅血肿清除术治疗高血压脑出血的临床比较[J].当代医学,2017,23(31):58-60.
[9]古运涛.神经内镜微创手术与开颅血肿清除术治疗高血压脑出血的临床分析[J].世界临床医学,2016,10(17):35,39.
[10]李学.比较高血压脑出血神经内镜微创手术与开颅血肿清除术的临床特点与疗效[J].继续医学教育,2016,30(9):112-113.
[11]白福平.高血压脑出血神经内镜微创手术与开颅血肿清除术的临床比较分析[J].医药前沿,2017,7(27):181-182.