摘要
目的探讨神经导航联合神经内镜小骨窗下治疗高血压脑出血的疗效。方法回顾分析山西省人民医院神经外科2019年4月至2023年5月收治的140例高血压脑出血患者的临床资料;采用神经导航联合神经内镜小骨窗治疗组90例(导航内镜微创组),采用颞瓣小骨窗显微镜手术组50例(显微镜组)。对比两组的血肿清除率、术中出血量、手术时间、住院时长、住院费用、术中扩大去骨瓣比例、二次手术比例及术后6个月的改良Rankin量表(MRS)评分。结果导航内镜微创组和显微镜组的血肿清除率[分别为(92.4±9.5)%和(81.3±11.6)%,P<0.05],术中出血量[分别为(100.0±15.3)ml和(230.0±24)ml,P<0.05],手术平均时间[分别为(1.9±0.5)h和(2.6±0.8)h,P<0.05],住院时间[分别为(11.4±2.4)d和(13.4±2.6)d,P>0.05],住院费用[分别为(4.25±0.85)万元和(4.88±0.90)万元,P>0.05],术中扩大去骨瓣比例[分别为3.33%和4.00%,P>0.05],术后少量渗血比例[分别为(27.8±4.3)%和(30.0±4.0)%,P>0.05],二次手术比例[分别为4.44%和4.0%,P>0.05],随访6个月MRS评分[分别为3.4±1.3和4.4±1.2,P<0.05]。结论神经导航联合内镜小骨窗治疗高血压脑出血微创、高效、预后佳,效果较好。
Objective To investigate the curative effects of neuronavigation combined with neuroendoscopy under small bone window in the clinical therapy of hypertensive intracerebral hemorrhage.Methods Clinical data of 140 patients with hypertensive cerebral hemorrhage who were admitted to our hospital from April 2019 to May 2023 were retrospectively analyzed.They were divided into two groups,one minimally invasive endoscopic navigation group(90 cases)receiving neuronavigation combined with neuroendoscopy under small bone window and the other microscopic group(50 cases)undergoing microsurgical operation of temporal flap under small bone window.Rate of hematoma evacuation,intraoperative amount of bleeding,operating time,length of hospital stay,hospitalization expenses,ratio of enlarged intraoperative bone flap removal,ratio of the second operation and MRS score 6 months postoperatively between these two groups were compared respectively.Results Rates of hematoma evacuation in minimally invasive endoscopic navigation group and microscopic group were(92.4±9.5)%and(81.3±11.6)%respectively(P<0.05).In addition,with respect to intraoperative amount of bleeding,minimally invasive endoscopic navigation group reached(100.0±15.3)ml while microscopic group attained(230.0±30)ml(P<0.05).Average operating time in the minimally invasive endoscopic navigation group and microscopic group were(1.9±0.5)h and(2.6±0.8)h respectively(P<0.05).Mean length of hospital stay was(11.4±2.4)d for minimally invasive endoscopic navigation group and(13.4±2.6)d for microscopic group(P>0.05).Expenses of hospitalization in the minimally invasive endoscopic navigation group and microscopic group were(4.25±0.85)(ten thousand yuan)and(4.88±0.90)(ten thousand yuan)respectively(P>0.05).Proportions of enlarged intraoperative bone flap removal in the minimally invasive endoscopic navigation group and microscopic group were 3.33%and 4.00%respectively(P>0.05).Besides,ratios of small amount of postoperative bleeding were(27.8±4.3)%and(30.0±4.0)%respectively(P>0.05).Proportions of the second operation were 4.44%and 4.0%respectively(P>0.05).Lastly,the MRS score after 6 months of follow-up were(3.4±1.3)and(4.4±1.2)respectively(P<0.05).Conclusion Neuronavigation combined with neuroendoscopy under small bone window in the clinical therapy of hypertensive intracerebral hemorrhage has plentiful advantages including minimal invasion,high efficiency and good prognosis.
作者
程刚
张世渊
贾禄
郭宇宏
刘小军
成睿
杨晓晨
李晓捷
霍宇琪
马久红
张秀峰
CHENG Gang;ZHANG Shiyuan;JIA Lu;GUO Yuhong;LIU Xiaojun;CHENG Rui;YANG Xiaochen;LI Xiaojie;HUO Yuqi;MA Jiuhong;ZHANG Xiufeng(Department of Neurosurgery,Shanxi Provincial People's Hospital,Taiyuan,Shanxi 030000,China)
出处
《中华神经外科疾病研究杂志》
CAS
2024年第4期27-30,共4页
Chinese Journal of Neurosurgical Disease Research
基金
山西省科学技术厅青年科技研究基金(201901D211515)。
关键词
神经导航
神经内镜
高血压脑出血
显微镜
疗效
Neuronavigation
Neuroendoscope
Hypertensive cerebral hemorrhage
Microscope
Curative effect
