神经内镜微创手术对高血压脑出血患者 神经功能及术后生活质量的影响

Effect of Neuroendoscopic Minimally Invasive Surgery on Neurological Function and Postoperative Quality of Life in Patients with Hypertensive Intracerebral Hemorrhage

摘要:

〔摘 要〕 目的：分析神经内镜微创手术和常规小骨窗开颅血肿清除术对高血压脑出血患者神经功能及术后生活质 量的影响，以得出更佳的治疗方案。方法：选取广东同江医院及佛山市第一人民医院 2020 年 4 月至 2021 年 4 月收治 的 100 例高血压脑出血患者，随机分为观察组和对照组，各 50 例。对照组给予常规小骨窗开颅血肿清除术治疗，观 察组给予神经内镜微创手术治疗，比较两组患者的各项疗效。结果：治疗后两组患者的美国国立卫生研究院卒中量表 （NIHSS）评分均有不同程度下降，日常生活活动量表（ADL）、格拉斯哥昏迷量表（GCS）、格拉斯哥预后评分（GOS） 评分均有不同程度上升，且观察组患者的 NIHSS 评分低于对照组，ADL 评分高于对照组，GCS 评分高于对照组， GOS 评分高于对照组，差异具有统计学意义（P ＜ 0.05）。观察组患者的手术时间短于对照组，术中出血量少于对照组， 住院时间短于对照组，血肿清除率高于对照组，差异具有统计学意义（P ＜ 0.05）。随访 6 个月，观察组患者有 1 例 （2.0 %）再出血，与对照组的 2 例（4.0 %）比较，差异无统计学意义（P ＞ 0.05）。随访 6 个月，观察组患者的并 发症发生率为 8.0 %，低于对照组的 32.0 %，差异具有统计学意义（P ＜ 0.05）。结论：高血压脑出血治疗中，神经 内镜微创手术较常规小骨窗开颅血肿清除术能更有效地改善患者神经功能及术后生活质量。

Abstract:

〔Abstract〕 Objective To analyze the effects of neuroendoscopic minimally invasive surgery and conventional small bone window craniotomy hematoma removal on neurological function and postoperative quality of life in patients with hypertensive intracerebral hemorrhage, so as to obtain a better treatment plan. Methods 100 patients with hypertensive intracerebral hemorrhage from April 2020 to April 2021 were selected and divided into the observation group and the control group, with 50 cases in each group. The control group was treated with conventional small bone window craniotomy for hematoma removal, and the observation group was treated with neuroendoscopic minimally invasive surgery, and the curative effects of the two groups were compared. Results After treatment, the scores of the National Institutes of Health Stroke Scale (NIHSS) in the two groups decreased to varying degrees, while the activities of daily living scale (ADL), glasgow coma scale (GCS) and glasgow prognosis score (GOS) increased to varying degrees. The NIHSS score in the observation group was lower than that in the control group, and the ALD score, GCS score and GOS score in the observation group were higher than those in the control group, and the differences were statistically significant (P < 0.05). The operation time of the observation group was shorter than that of the control group, the amount of intraoperative blood loss of the observation group was less than that of the control group, the length of hospitalization of the observation group was shorter than that of the control group, and the hematoma clearance rate of the observation group was higher than that of the control group, all with statistical significances (P < 0.05). After 6 months of follow-up, there was 1 case (2.0 %) of rebleeding in the observation group, compared with 2 cases (4.0 %) in the control group, and there was no statistical significance (P > 0.05). After 6 months of follow-up, the incidence of complications in the observation group was 8.0%, lower than 32.0 % in the control group , and the difference was statistically significant (P < 0.05). Conclusion In the treatment of hypertensive intracerebral hemorrhage, neuroendoscopic minimally invasive surgery is more effective than conventional small bone window craniotomy hematoma removal in improving neurological function and postoperative quality of life.