摘要
目的:观察对高血压性脑出血患者采取神经内镜下微创术治疗的血肿清除效果,并观察对患者神经功能、应激反应及预后的影响。方法:选择庆阳市人民医院2018年1月—2022年1月收治的74例高血压性脑出血患者,按随机数表法分为两组,各37例。对照组实施传统开颅术治疗,治疗组实施神经内镜下微创术治疗。观察两组血肿清除效果、神经功能、生活自理能力、应激反应及预后情况。结果:治疗组手术时间短于对照组,术中出血量少于对照组,血肿清除率高于对照组,差异有统计学意义(P<0.001)。术后3 h,两组的皮质醇(Cor)及内皮素(ET)水平比较,差异无统计学意义(P>0.05);两组术后24 h的Cor、ET水平均较术后3 h上升,但治疗组上升幅度小于对照组,差异有统计学意义(P<0.001)。术后7 d,两组的美国国立卫生院神经功能缺损评分(NIHSS)、生活自理能力评分比较,差异无统计学意义(P>0.05);两组术后3个月的NIHSS评分均较术后7 d降低,生活自理能力评分均术后7 d提高,且治疗组NIHSS评分低于对照组,生活自理能力评分高于对照组,差异均有统计学意义(P<0.001)。治疗组预后良好率为81.08%,高于对照组的59.46%,差异有统计学意义(P<0.05)。结论:高血压性脑出血经神经内镜下微创术治疗,血肿清除效果佳,手术时间短,术中出血量少,并有助于改善患者神经功能,提高生活自理能力,降低应激反应,且术后预后良好。
Objective:To observe the hematoma clearance effect of minimally invasive surgery under neuroendoscope in patients with hypertensive intracerebral hemorrhage,and to observe the impact on the neurological function,stress response and prognosis of patients.Method:A total of 74 patients with hypertensive intracerebral hemorrhage admitted to Qingyang People's Hospital from January 2018 to January 2022 were randomly divided into two groups,37 cases in each group.The control group was treated with traditional craniotomy,and the treatment group was treated with minimally invasive surgery under neuroendoscope.The hematoma clearance effect,nerve function,self-care ability,stress response and prognosis of the two groups were observed.Result:The operation time of the treatment group was shorter than that of the control group,the amount of intraoperative bleeding was less than that of the control group,and the hematoma clearance rate was higher than that of the control group,the differences were statistically significant(P<0.001).At 3 hours after operation,there were no statistically significant differences in the levels of cortisol(Cor)and endothelin(ET)between the two groups(P>0.05).At 24 hours after operation,the levels of Cor and ET in the two groups were higher than those at 3 hours after operation,but the increase in the treatment group were smaller than those in the control group,the differences were statistically significant(P<0.001).At 7 days after operation,there were no significant differences between the two groups in the scores of National Institute of Health stroke scale(NIHSS)and self-care ability(P>0.05).Three months after operation,the NIHSS scores of the two groups were lower than those of the 7 days after operation,and the scores of self-care ability were higher than those of the 7 days after operation,and the NIHSS score of the treatment group was lower than that of the control group,and the score of self-care ability was higher than that of the control group,the differences were statistically significant(P<0.001).The good prognosis rate of the treatment group was 81.08%,which was higher than 59.46%of the control group,the difference was statistically significant(P<0.05).Conclusion:The treatment of hypertensive intracerebral hemorrhage with minimally invasive surgery under neuroendoscope has good hematoma removal effect,short operation time,less intraoperative bleeding,and is helpful to improve the patients'neurological function,improve the ability of self-care,reduce stress response,and it has a good prognosis after operation.
作者
郭伟
刘颉
GUO Wei;LIU Jie(不详;Qingyang People's Hospital,Qingyang 745000,China)
出处
《中外医学研究》
2023年第10期27-31,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
高血压性脑出血
神经内镜下微创术
血肿
神经功能
预后
Hypertensive cerebral hemorrhage
Neuroendoscopic minimally invasive surgery
Hematoma
Nerve function
Prognosis
