摘要
目的分析神经内镜微创手术治疗脑出血患者的手术成功率、术后并发症及预后的效果。方法回顾性分析苏州大学附属太仓医院2019年3月—2023年4月收治的80例脑出血患者的临床资料,根据治疗方案的差异,随机分为两组。研究组40例患者采取神经内镜术经额入路,对照组40例患者采取显微镜下行开颅血肿清除术。比较两组患者的临床疗效,采用美国国立卫生研究院卒中量表(NIHSS)、格拉斯哥昏迷量表(GCS)比较两组患者治疗前后的神经功能,采用痴呆评分量表(DRS)进行疾病风险评估。采用蒙特利尔认知评估量表(MoCA)评价患者认知功能,采用简化Fugl-Meyer运动功能评分评价患者肢体功能,采用Barthel指数评分评价患者日常生活能力,并记录分析两组患者住院时间、术后并发症情况。结果研究组患者在手术指标方面(手术时间、术中创伤出血量、术后并发症、住院时间)较对照组显著改善(P<0.05)。与对照组比较,研究组患者在术后1个月、2个月、3个月Barthel指数评分较高,术后NIHSS、DRS评分均显著降低,组间差异有统计学意义(P>0.05)。在治疗后认知和肢体功能恢复方面,研究组MoCA评分、Fugl-Meyer评分均显著高于对照组,组间差异有统计学意义(P>0.05)。结论对脑出血患者治疗采取神经内镜微创手术治疗,临床疗效好,显著改善围手术期指标,并降低术后并发症发生率,更有利于患者术后神经认知功能、肢体功能的恢复。
Objective To analyze the feasibility,postoperative complications and prognosis of patients with cerebral hemorrhage treated by minimally invasive neuroendoscopic surgery.Methods The clinical data of 80 patients with cerebral hemorrhage admitted to Taicang Hospital Affiliated to Soochow University from March 2019 to April 2023 were analyzed retrospectively.They were randomly divided into two groups according to the differences in treatment plans.40 patients in the study group underwent neuroendoscopy via frontal approach,and 40 patients in the control group underwent endoscopic craniotomy hematoma removal under microscope.The clinical efficacy of the two groups was compared,the neurological function of the two groups before and after treatment was compared using the National Institutes of Health Stroke Scale(NIHSS)and Glasgow coma scale(GCS),and the disease risk was assessed using the dementia rating scale(DRS)score.The Montreal Cognitive Assessment Scale(MoCA)was used to evaluate the cognitive function of the patients,the simplified Fugl-Meyer motor function score was used to evaluate the limb function of the patients,and the Barthel index score was used to evaluate the daily living ability of the patients,and the length of hospital stay and postoperative complications of the two groups were recorded and analyzed.The length of hospital stay and postoperative complications of the patients in the two groups were recorded and analyzed.Results In terms of surgical indicators(operation time,intraoperative trauma blood loss,postoperative complications,length of hospital stay),the study group was better than the control group,and the data were statistically significant(P<0.05).Compared with the control group,the Barthel index score of the study group was higher at 1 month,2 months and 3 months after surgery,and the scores of NIHSS and DRS were significantly decreased,with statistical significance between the groups(P<0.05).In terms of cognitive and limb function recovery after treatment,the MoCA score and Fugl-Meyer score of the study group were significantly higher than those of the control group,and the differences between the groups were statistically significant(P<0.05).Conclusion The treatment of cerebral hemorrhage patients with minimally invasive neuroendoscopic surgery has good clinical efficacy,significantly improves perioperative indicators,reduces the incidence of postoperative complications,and is more conducive to the recovery of postoperative neurocognitive function and limb function of patients.
作者
王彩红
邱玉发
姜明
徐清
左刚
WANG Caihong;QIU Yufa;JIANG Ming(Department of Neurosurgery,Taicang Hospital Affiliated to Soochow University,Taicang,215400,China)
出处
《临床神经外科杂志》
2023年第6期691-695,共5页
Journal of Clinical Neurosurgery
基金
苏州市姑苏卫生人才计划培养项目(GSWS2020114)。
关键词
神经内镜微创手术
脑出血
临床疗效
并发症
neuroendoscopic minimally invasive surgery
cerebral hemorrhage
clinical effect
complication
