精准定位下内镜治疗高血压基底核出血疗效及安全性分析
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摘要
目的探究精准定位下内镜治疗高血压基底核出血的疗效及安全性。方法回顾分析2015年1月—2017年5月期间郑州市第三人民医院收治的50例高血压基底核出血患者的治疗资料,根据手术方法分为试验组与对照组,每组例数均等,试验组采用精准定位下神经内镜微创手术治疗,对照采用传统开颅手术治疗。分别观察两组患者术中指标(手术所需时间、术中出血量)、住院所需时间、血肿清除率、临床治疗效果、GCS评分。结果试验组手术所需时间、术中出血量、住院所需时间、GCS评分均低于对照组[(68.21±20.81) min<(167.25±26.84)min;(48.62±1.33)ml<(264.28±17.28)ml;(11.97±1.74)d<(21.46±1.82)d;(21.92±1.53)分<(36.94±1.32)分];血肿清除率、临床治疗总有效率均高于对照组[(91.01±7.58)%>(86.21±5.12)%;96.00%>68.00%],差异有统计意义(P<0.05)。结论在精准定位下行神经内镜微创手术治疗高血压基底核出血利于改善手术指标,提升血肿清除率以及治疗效果,值得临床广泛推广应用。
Objective To investigate the efficacy and safety of endoscopy in the treatment of hypertensive basal nucleus hemorrhage. Methods 50 patients with hypertensive basal nucleus hemorrhage in The Third People's Hospital of Zhengzhou from January,2015 to May,2017 were retrospectively analyzed. According to the operative methods,the patients were divided into experimental group and control group,with equal number of cases in each group. The experimental group were treated with endoscopy minimally invasive surgery under precise positioning,while the control group were treated with traditional craniotomy. The intraoperative indexes(operative time and intraoperative blood loss),hospitalization time,hematoma clearance rate and GCS score were observed in the two groups. Results The time required,intraoperative bleeding volume,hospitalization time and GCS score of the experimental group were lower than those in the control group [(68.21±20.81)min<(167.25±26.84)min,(48.62±1.33)ml<(264.28±17.28)ml,(11.97±1.74)d<(21.46±1.82)d;(21.92±1.53)scores<(36.94±1.32)scores]. The hematoma clearance rate and the total effective rate of clinical treatment were higher than those in the control group [(91.01±7.58)>(86.21±5.12);96.00%>68.00%],P<0.05.Conclusion Endoscopic minimally invasive neurosurgery for hypertensive basal nucleus hemorrhage is beneficial to improve the surgical index,and improve the hematoma clearance rate and therapeutic effect. So it is worthy of extensive clinical application.
Objective To investigate the efficacy and safety of endoscopy in the treatment of hypertensive basal nucleus hemorrhage. Methods 50 patients with hypertensive basal nucleus hemorrhage in The Third People's Hospital of Zhengzhou from January,2015 to May,2017 were retrospectively analyzed. According to the operative methods,the patients were divided into experimental group and control group,with equal number of cases in each group. The experimental group were treated with endoscopy minimally invasive surgery under precise positioning,while the control group were treated with traditional craniotomy. The intraoperative indexes(operative time and intraoperative blood loss),hospitalization time,hematoma clearance rate and GCS score were observed in the two groups. Results The time required,intraoperative bleeding volume,hospitalization time and GCS score of the experimental group were lower than those in the control group [(68.21±20.81)min<(167.25±26.84)min,(48.62±1.33)ml<(264.28±17.28)ml,(11.97±1.74)d<(21.46±1.82)d;(21.92±1.53)scores<(36.94±1.32)scores]. The hematoma clearance rate and the total effective rate of clinical treatment were higher than those in the control group [(91.01±7.58)>(86.21±5.12);96.00%>68.00%],P<0.05.Conclusion Endoscopic minimally invasive neurosurgery for hypertensive basal nucleus hemorrhage is beneficial to improve the surgical index,and improve the hematoma clearance rate and therapeutic effect. So it is worthy of extensive clinical application.
引文
[1]杜战锋.经侧裂-岛叶入路显微手术治疗高血压性基底核区脑出血的临床疗效[J].神经损伤与功能重建,2016,11(1):63-65.
[2]黎源,黄启锐,黄文飞,等.简易颅表定位CT引导下微创手术治疗基底核区高血压性脑出血[J].中国微侵袭神经外科杂志,2016,21(3):109-111.
[3]冯才政.小骨窗入路显微外科治疗高血压基底核区脑出血的有效性及安全性分析[J].河南医学研究,2017,26(13):2411-2412.
[4]王晓毅,成刚.经侧裂-岛叶入路显微手术治疗高血压性基底核区脑出血的临床疗效分析[J].临床医药文献电子杂志,2017,4(45):8715-8715.
[5]陈向荣,吴宗涛,杜菊梅,等. 3D-Slicer软件辅助神经内镜颅内血肿清除术与开颅手术治疗长轴型高血压性基底核区出血临床效果的对比研究[J].实用心脑肺血管病杂志,2017,25(10):83-87.
[6]邹西峰,李兵,罗鹏,等.血肿腔内照明辅助微创治疗老年高血压病人基底核血肿[J].中国微侵袭神经外科杂志,2017,22(11):481-484.
[7]乔潜林,张举英,李文.超早期及早期小骨窗微创血肿清除术治疗高血压基底核区出血的临床疗效比较[J].实用心脑肺血管病杂志,2016,24(4):64-66.
[8]田海龙,王益华,何伟,等.无牵拉技术辅助下经侧裂-岛叶入路显微手术治疗基底核区高血压性脑出血[J].中国微侵袭神经外科杂志,2017,22(1):7-10.
[2]黎源,黄启锐,黄文飞,等.简易颅表定位CT引导下微创手术治疗基底核区高血压性脑出血[J].中国微侵袭神经外科杂志,2016,21(3):109-111.
[3]冯才政.小骨窗入路显微外科治疗高血压基底核区脑出血的有效性及安全性分析[J].河南医学研究,2017,26(13):2411-2412.
[4]王晓毅,成刚.经侧裂-岛叶入路显微手术治疗高血压性基底核区脑出血的临床疗效分析[J].临床医药文献电子杂志,2017,4(45):8715-8715.
[5]陈向荣,吴宗涛,杜菊梅,等. 3D-Slicer软件辅助神经内镜颅内血肿清除术与开颅手术治疗长轴型高血压性基底核区出血临床效果的对比研究[J].实用心脑肺血管病杂志,2017,25(10):83-87.
[6]邹西峰,李兵,罗鹏,等.血肿腔内照明辅助微创治疗老年高血压病人基底核血肿[J].中国微侵袭神经外科杂志,2017,22(11):481-484.
[7]乔潜林,张举英,李文.超早期及早期小骨窗微创血肿清除术治疗高血压基底核区出血的临床疗效比较[J].实用心脑肺血管病杂志,2016,24(4):64-66.
[8]田海龙,王益华,何伟,等.无牵拉技术辅助下经侧裂-岛叶入路显微手术治疗基底核区高血压性脑出血[J].中国微侵袭神经外科杂志,2017,22(1):7-10.