摘要
目的:探讨采用立体定向引导下的前额锁孔入路神经内镜血肿清除术治疗高血压基底节区脑出血的临床价值。方法:选取2016年1月-2017年6月本院收治的高血压基底节区脑出血患者86例。依照入院先后顺序对其进行排号,并纳入电脑通过软件进行随机分组,分为参照组和研究组,各43例。参照组给予传统立体定向血肿穿刺引流术治疗,研究组给予立体定向引导下前额锁孔入路神经内镜血肿清除术治疗。比较两组手术时间、术后第1天血肿清除率、术后再出血率、并发症发生率、术后1个月死亡率及术后6个月的预后效果。结果:研究组手术时间长于参照组,术后第1天血肿清除率显著高于参照组,术后再出血率显著低于参照组,比较差异均有统计学意义(P<0.05);研究组并发症发生率及死亡率均显著低于参照组,预后良好率显著优于参照组,比较差异均有统计学意义(P<0.05)。结论:临床采用立体定向引导下的前额锁孔入路神经内镜血肿清除术治疗高血压基底节区脑出血的手术时间与传统立体定向血肿穿刺引流术相比显著延长,但前者能明显提高血肿清除率,同时术后再出血率、并发症发生率及病死率均明显下降,对于患者预后改善显著,值得研究推广。
Objective：To explore the clinical value of endoscopic hematoma removal by anterior frontal keyhole approach under stereotactic guidance in treatment of hypertensive basal ganglia intracerebral hemorrhage.Method：A total of 86 patients with hypertensive basal ganglia intracerebral hemorrhage admitted in our hospital from January 2016 to June 2017 were selected.According to the order of hospitalization order,they were randomly divided intoreference group andstudy group,43 cases in each group.The reference group were treated with traditional stereotactic hematoma puncture and drainage,whilestudy group were treated with stereotactic guided anterior keyhole approach for endoscopic hematoma removal.The operation time,postoperative first days hematoma clearance rate,postoperative rebleeding rate,complication rate,postoperative 1 month mortality rate and postoperative 6 months prognosis effect between two groups were compared.Result：The operation time ofstudy group was longer than that ofreference group,postoperative first days hematoma clearance rate was significantly higher than that of reference group,the postoperative rebleeding rate was significantly lower than that of reference group,the differences were statistically significant（P〈0.05）.The incidence of complications and mortality ofstudy group were significantly lower than those ofreference group,and the good prognosis was significantly better than that ofreference group,the differences were statistically significant（P〈0.05）.Conclusion：The operation time of endoscopic hematoma removal by anterior frontal keyhole approach under stereotactic guidance in clinical treatment of hypertensive basal ganglia intracerebral hemorrhage is significantly longer than that of traditional stereotactic hematoma puncture drainage,but it can improve the clearance rate of hematoma,reduce the postoperative rebleeding rate,the incidence of complications and mortality,and improve the prognosis of the patients,thus it is worth promoting.
作者
郑一科
赖勇
苏瑞林
ZHENG Yike;LAI Yong;SU Ruilin(Central People’s Hospital of Zhanjiang,Zhanjiang 524000,Chin)
出处
《中国医学创新》
CAS
2018年第15期64-67,共4页
Medical Innovation of China
关键词
神经内镜
血肿清除术
高血压脑出血
基底节区
Neuroendoscopy
Hematoma removal
Hypertensive intracerebral hemorrhage
Basal ganglia
作者简介
通信作者：郑一科
