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Received:April 08, 2021 Published Online:November 20, 2021
Received:April 08, 2021 Published Online:November 20, 2021
中文摘要: 目的 分析神经内镜微创手术对基底节脑出血患者脑氧代谢及预后的影响。方法 选取于2019年11月至2021年3月国药葛洲坝中心医院诊治的基底节脑出血患者120例分为两组,内镜组60例,行神经内镜手术;开颅组60例,行开颅手术;比较两组脑氧代谢、神经功能及预后。结果 内镜组手术时间、术中出血量、ICU入住时间、住院时间均短于开颅组(P<0.01)。内镜组手术结束24 h血肿残余量低于开颅组,血肿清除率高于开颅组(P<0.01)。术后,两组NIHSS量表、GCS量表评分均下降,且内镜组评分低于开颅组(P<0.01)。术后1周两组脑氧代谢均改善,且内镜组改善程度高于开颅组(P<0.01)。内镜组术后3个月预后良好率高于开颅组(80.00% vs 60.00%,χ2=5.714,P=0.017)。内镜组术后3周内并发症发生率低于开颅组(3.33% vs 16.67%, χ2=5.926,P=0.015)。结论 神经内镜微创手术可提高基底节脑出血患者的血肿清除率,脑氧代谢恢复显著,预后好。
Abstract:Objective To analyze the effect of neuroendoscopic minimally invasive surgery on cerebral oxygen metabolism and prognosis in patients with basal ganglia hemorrhage (BGH).Methods A total of 120 patients with BGH diagnosed and treated from November 2019 to March 2021 in Gezhouba Central Hospital of Sinopharm were selected and divided into two groups, 60 patients in the endoscopy group underwent neuroendoscopic surgery; 60 patients in the craniotomy group underwent craniotomy. The cerebral oxygen metabolism, neurological function and prognosis of the two groups were compared. Results The operation time, intraoperative blood loss, ICU stay and hospital stay in endoscopic group were shorter than those in craniotomy group (P<0.01). Compared with craniotomy group, the residual amount of hematoma was lower, and the hematoma clearance rate was higher in endoscopic group (P<0.01). After operation, the scores of the NIHSS scale and GCS scale of the two groups decreased, and the scores of the endoscopy group were lower than those of the craniotomy group (P<0.01). The cerebral oxygen metabolism of the two groups was improved at 1 week after operation, and the metabolic improvement of the endoscopic group was higher than that of the craniotomy group (P<0.01). The prognosis good rate of the endoscopic group was higher than that of the craniotomy group at 3 months after surgery (80.00% vs 60.00%, χ2=5.714, P=0.017). The incidence of complications in the endoscopic group was lower than that in the craniotomy group within 3 weeks after surgery (3.33% vs 16.67%, χ2=5.926, P=0.015).Conclusion Neuroendoscopic surgery can improve the hematoma clearance rate of patients with BGH, the cerebral oxygen metabolism recovers significantly, and the prognosis is good.
文章编号: 中图分类号:R651.1 文献标志码:A
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